Fetal and postnatal growth and blood pressure at the age of 2 years. The Generation R Study

Objectives To examine which fetal and postnatal growth characteristics are associated with blood pressure (BP) in children at the age of 2 years. Methods This study was embedded in the Generation R Study, a population-based prospective cohort study from early fetal life onwards. Fetal ultrasound examinations were carried out at the visits in one of the research centers in early, mid- and late pregnancy. Fetal femur length standard deviation scores (SDS) were used as a proxy for body length SDS in the prenatal data. BP measurements were performed at the age of 2 years. Analyses were performed in 566 children. Results Inverse tendencies for fetal femur length and estimated fetal weight in mid-pregnancy and late pregnancy with SBP at the age of 2 years were found. The association was only significant for femur length in late pregnancy [-1.22 (95% confidence interval (CI), -2.09, -0.34) mmHg/femur length SDS score]. Length change from late pregnancy to the age of 2 years was positively associated with SBP and DBP [0.97 (95% CI, 0.27,1.66) mmHg and 0.82 (95% CI, 0.09, 1.55) mmHg per SDS length change, respectively]. A similar association between weight change and SBP was found. Conclusion Increased skeletal and nonskeletal growth rates from late pregnancy to the age of 2 years are associated with somewhat higher SBP and DBP in early childhood. Replication of these findings and studies examining the underlying biological pathways and the long-term consequences are needed.

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