The Journal of Pediatrics
Volume 151, Issue 6 , Pages 670-674, December 2007

Size at Birth, Infant Growth, and Blood Pressure at Three Years of Age

  • Mandy B. Belfort, MD, MPH

      Affiliations

    • Division of Newborn Medicine, Children’s Hospital Boston, Boston, MA
    • Corresponding Author InformationReprint requests: Mandy B. Belfort, MD, MPH, Division of Newborn Medicine, Hunnewell 437, Children’s Hospital Boston, 300 Longwood Ave, Boston, MA 02115.
  • ,
  • Sheryl L. Rifas-Shiman, MPH

      Affiliations

    • Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care, Boston, MA
  • ,
  • Janet Rich-Edwards, ScD

      Affiliations

    • Division of Women’s Health, Brigham and Women’s Hospital, Boston, MA
    • Department of Epidemiology, Harvard School of Public Health, Boston, MA
  • ,
  • Ken P. Kleinman, ScD

      Affiliations

    • Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care, Boston, MA
  • ,
  • Matthew W. Gillman, MD, SM

      Affiliations

    • Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care, Boston, MA
    • Department of Nutrition, Harvard School of Public Health, Boston, MA.

Received 7 December 2006; received in revised form 16 March 2007; accepted 1 May 2007. published online 13 August 2007.

Objectives

Our aim was to determine the extent to which infant growth—in weight-for-length—from birth to 6 months is associated with systolic blood pressure (SBP) at 3 years and to determine whether this association varies with birth size.

Study design

In 530 children from the prospective cohort Project Viva, we measured birth length and 6-month weight and length with research standard instruments and SBP at age 3 years with a Dinamap automated recorder. We derived weight-for-length z-scores (WFL-z) and analyzed data with mixed effects regression models.

Results

The mean (SD) WFL-z was 0.47 (0.75) at birth and 0.70 (0.96) at 6 months. Mean (SD) SBP at 3 years was 91.7 (9.4) mm Hg. After adjusting for confounding variables and birth WFL-z, child SBP was 1.0 mm Hg (95% CI 0.2, 1.8) higher for each z-score increment in 6-month WFL-z. The SBP of children in the lowest birth WFL-z quartile and the highest 6-month WFL-z quartile was 5.5 mm Hg (95% CI 2.6, 8.4) higher than that of children in the highest birth and lowest 6-month WFL-z quartiles.

Conclusions

More rapid increase in weight-for-length, a measure of adiposity, in the first 6 months of life is associated with higher early childhood SBP, particularly in children who are thin at birth.

Abbreviations: BMI, Body mass index, CI, Confidence interval, SBP, Systolic blood pressure, WFL-z, Weight-for-length z-score

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 Supported by NIH (HD 34568, HL 64925, HL 68041), Harvard Medical School, Harvard Pilgrim Health Care Foundation, and Harvard Pediatric Health Services Research Fellowship Program (HRSA T32 HP10018).

PII: S0022-3476(07)00459-3

doi:10.1016/j.jpeds.2007.05.010

The Journal of Pediatrics
Volume 151, Issue 6 , Pages 670-674, December 2007