Early predictors of hypertension in prematurely born adolescents.

ABSTRACT

OBJECTIVE: To assess the blood pressure of former preterm and term matched adolescent controls and to identify risk factors associated with blood pressure at 16 years. DESIGN: Observational cohort study. Secondary analysis of a randomized clinical trial. SETTING: Three academic centres participating in the Multicenter Indomethacin IVH Prevention Trial. PARTICIPANTS: A total of 296 children born in 1989-1992 with birth weights 600 to <1250 g who participated in the Multicenter Indomethacin IVH Prevention Trial and 95 term controls were evaluated at 16 years. MAIN OUTCOME MEASURES: Blood pressure and predictors of blood pressure. RESULTS: The adjusted mean difference in blood pressure for preterm adolescents was 5.1 mm Hg; p=0.002 for systolic and 2.1 mm Hg; p=0.027 for diastolic blood pressure. Among preterms, the primary predictors of increased systolic blood pressure were weight gain velocity between birth and 36 months (b=8.54, p<0.001), pre-eclampsia (b=5.67, p=0.020), non-white race (b=3.77, p=0.04) and male gender (b=5.09). Predictors of diastolic blood pressure were weight gain velocity between birth and 36 months (b=4.69, p=0.001), brain injury (b=6.51, p=0.002) and male gender (b=-2.4, p=0.02). CONCLUSIONS: Early programming secondary to increased early weight gain velocity, intrauterine stress and neonatal brain injury may all contribute to risk of increased blood pressure among former preterm adolescents.