Birth weight is inversely associated with blood pressure and serum aldosterone and cortisol levels in children

Abstract

Context: Low birth weight has been independently associated with adult hypertension, and renin-angiotensin system (RAS) plays a role in this connection.

Objective: To characterize the associations between birth weight (BW) and serum aldosterone (SA), serum cortisol, plasma renin activity (PRA) and blood pressure (BP).

Design: Cross-sectional study.

Subjects: Children from the community born at a gestational age >32 weeks.

Methods: Systolic and diastolic BP indices (SBPi and DBPi) were calculated using the observed BP/50th percentile BP for gender, age and stature. BW was transformed to a standard deviation score (SDS) for gestational age, whereas SA, serum cortisol and PRA were transformed using the natural log.

Results: We selected 288 subjects between the ages of 4·9 and 15·5 years (Females, 50%). After adjusting for body mass index (BMI) SDS and Tanner, multiple regression analysis revealed that BW (SDS) was both independently and inversely associated with the natural log of SA (β = -0·065; P = 0·039), the natural log of serum cortisol (β = -0·064; P = 0·009), SBPi (β = -0·012; P = 0·020) and DBPi (β = -0·023; P = 0·002). An association was not observed with PRA (P = 0·178) and aldosterone renin ratio (ARR) (P = 0·452). Serum cortisol levels were positively associated with SA (r = 0·125; P = 0·034), while an association with PRA (P = 0·251) and ARR (P = 0·052) was not observed.

Conclusions: The results of this study demonstrate an inverse association between birth weight and blood pressure and serum aldosterone and cortisol levels. This association is independent of BMI and Tanner, suggesting foetal programming of the hypothalamic-pituitary-adrenal axis.