Abstract 3989: Accelerated Early Postnatal Growth is Associated with Increased Blood Pressure and Body Mass Index in Childhood
Background: Accelerated early growth promotes atherosclerosis in experimental models and is associated with increased vascular risk in adults. However the underlying mechanisms and their time course are poorly understood. We have assessed the impact of early postnatal growth rate on blood pressure and BMI in childhood.
Methods: We studied 4652 children aged 10 years nested within the Avon Longitudinal Study of Parents and Children (ALSPAC). Blood pressure was measured and BMI was calculated as weight (kg)/ height (m)2. Lipid profile was assessed in all children at the age of 7years. Weight and length were recorded at birth and within a period of 2 months. All values were converted to z scores. Change in growth in the first two months was assessed as the change in weight and length z score between birth and the first two months of life.
Results: Faster weight gain in the first two months was associated with increased systolic blood pressure (SBP) at 10 years later (0.5 [0.2, 0.9]; B [95%CI]; p<0.01). This association remained after adjusting for birthweight z score, sex, heart rate, BMI at 10 years and lipoprotein profile. In addition, faster weight gain was also associated with increased BMI at 10 years (0.2 [0.06, 0.29]; p<0.01). Birthweight z score was not independently associated with SBP. When children were assessed in quartiles of weight change the highest quartile had 1.69mmHg increase in blood pressure compared to the lowest weight gain quartile (104.4±0.6 vs 102.7±0.2mmHg (mean±SE) respectively; p<0.01). Similarly BMI was increased from the lowest to the highest quartile of weight change (18.1±0.1 to 18.6±0.2 kg/m2 respectively; p<0.01). Changes in length measurements were not predictive of BMI or SBP at 10 years.
Conclusion: We have demonstrated that more rapid weight gain during the first two months of life is associated with increased SBP and BMI as early as 10 years of age in a healthy, prospectively followed, contemporary cohort. Further studies are needed to assess the implications of these abnormalities for cardiovascular risk in adulthood.