Increased blood pressure but normal renal function in adult women born preterm

Abstract

It has been suggested that children born small for gestational age may develop hypertension and renal dysfunction in adulthood due to impaired fetal kidney development. Very little information on this issue is available on children born preterm. The objective of this study was to investigate the relationship between birth weight, blood pressure, and kidney function in adult subjects who were born preterm or born small for gestational age (SGA).

Study design: Subjects (n = 50), all women born between 1966 and 1974, were evaluated at a mean age of 26 +/- 1.9 years. They were allocated to three groups: (1) born before gestational week 32 (n = 15), (2) born full term with birth weight < 2600 g (n = 18) (SGA), and (3) controls, born full term with appropriate birth weight (n = 17). Casual blood pressure, ambulatory 24-h blood pressure (ABPM), glomerular filtration rate (GFR), renal plasma flow (ERPF) and urinary albumin excretion were determined.

Results: Preterms had significantly higher casual systolic and mean arterial blood pressure levels compared to controls (123 +/- 13 vs 110 +/- 7 mmHg, P < 0.01, and 87 +/- 9 vs 79 +/- 6 mmHg, P < 0.005, respectively). ABPM was not significantly different between the groups. When the number of systolic recordings > 130 mmHg/subject during ABPM was calculated, the preterms had significantly more recordings above this value (P < 0.05) as well as a significantly increased area under the curve > 130 mmHg and > 140 mmHg systolic (P < 0.05) compared to the controls. SGA subjects were not significantly different from controls. There were no significant differences in GFR, ERPF or urinary albumin excretion between the three groups.

Conclusion: Women born preterm seem to have a disturbance in blood pressure regulation in adulthood, a finding that is not observed for those born small for gestational age. Kidney function in early adulthood seems to be normal in subjects born preterm or small for gestational age.