Racial disparities in the association between birth weight in the term infant and blood pressure at age 7 years: Results from the Collaborative Perinatal Project
Racial disparities in the association between birth weight in the term infant and blood pressure at age 7 years: Results from the Collaborative Perinatal Project
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DOI：
10.1681/asn.2005090898
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发表时间：
2006-09-01
影响因子：
13.6
通讯作者：
Furth, Susan L.
中科院分区：
文献类型：
--
作者：
Hemachandra, Anusha H.;Klebanoff, Mark A.;Furth, Susan L.
世界各地的研究表明，血压与出生体重呈负相关，但很少有研究纳入黑人个体。美国国家围产期合作项目对 58,960 名孕妇及其所生的后代进行了 7 年的跟踪调查。在这项事后分析中，所有没有肾脏或心脏病的足月白人或黑人儿童都被包括在内（n = 29,710）。在 7 岁时评估出生体重和其他危险因素对收缩压 (SBP) 和舒张压 (DBP) 的影响。与白人儿童相比，黑人儿童的平均出生体重和 7 岁时体重指数略低（出生体重 3.14 +/- 0.48 对比 3.32 +/- 0.46 kg [P < 0.001]；体重指数 15.8 +/- 2.0 对比 16.3 +/- 2.0 [P < 0.001]）。与白人母亲相比，黑人母亲吸烟的可能性较小（41％对52％），贫血程度更高（23％对7％），并且更有可能生活在贫困中（72％对39％）。在线性回归中，种族和出生体重在预测 SBP 方面存在显着的交互作用 (P = 0.002)。在双变量分析中，黑人儿童的出生体重与收缩压 (β = 0.87) 和舒张压 (β = 1.14) 呈正相关 (P < 0.001)，但与白人儿童中的任何一个均不相关。将母亲贫困、教育水平和怀孕期间贫血添加到模型中后，出生体重仍然是黑人儿童 SBP 的显着正向预测因子（β = 0.89，P < 0.001），但对于白人儿童则不然（β = 0.02，P = 0.17）。黑人和白人儿童的出生体重与收缩压之间的关系有所不同。宫内生长受限相关高血压的病因似乎具有种族敏感性；因此，未来对“巴克假说”中种族差异的研究可能有助于理解胎儿高血压的机制。
BP has been inversely associated with birth weight in studies worldwide, but few studies have included black individuals. The US National Collaborative Perinatal Project followed 58,960 pregnant women and their resultant offspring for 7 yr. In this post hoc analysis, all term white or black children without kidney or heart disease were included (n = 29,710). The effect of birth weight and other risk factors on systolic (SBP) and diastolic BP (DBP) was evaluated at 7 yr. Mean birth weight and body mass index at 7 yr were slightly lower for black compared with white children (birth weight 3.14 +/- 0.48 versus 3.32 +/- 0.46 kg [P < 0.001]; body mass index 15.8 +/- 2.0 versus 16.3 +/- 2.0 [P < 0.001]). Compared with white mothers, black mothers were less likely to smoke (41 versus 52%), were more anemic (23 versus 7%), and were more likely to live in poverty (72 versus 39%). In linear regression, there was significant interaction between race and birth weight in predicting SBP (P = 0.002). In bivariate analysis, birth weight was positively associated with SBP (beta = 0.87) and DBP (beta = 1.14) in black children (P < 0.001) but not associated with either in white children. With maternal poverty, educational level, and anemia during pregnancy added to the model, birth weight remained a significant positive predictor of SBP (beta = 0.89, P < 0.001) in black but not in white children (beta = 0.02, P = 0.17). The association between birth weight and SBP differs between black and white children. The cause of intrauterine growth restriction-associated hypertension seems to be race sensitive; therefore, future studies of racial disparities in the "Barker hypothesis" may help in the understanding of the mechanism of fetal programming of hypertension.