Persistent high blood pressure and renal dysfunction in preterm infants during childhood
Background Infants born very preterm (≤32 weeks gestational age, GA) and very-low birth weight (≤1500 g; PT-VLBW) demonstrate high systolic blood pressure (SBP), renal dysfunction, and obesity at 6 months–3 years and in early adulthood. Their parallel measurement and progression during childhood is...
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| Veröffentlicht in: | Pediatric research 2023-01, Vol.93 (1), p.217-225 |
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| creator | Wickland, Jessica Steven Brown, L. Blanco, Valerie Heyne, Roy Turer, Christy Rosenfeld, Charles R. |
| description | Background
Infants born very preterm (≤32 weeks gestational age, GA) and very-low birth weight (≤1500 g; PT-VLBW) demonstrate high systolic blood pressure (SBP), renal dysfunction, and obesity at 6 months–3 years and in early adulthood. Their parallel measurement and progression during childhood is unclear.
Methods
We reenrolled 62/120 patients originally seen at 1–3 years at 10–13 years and remeasured anthropometric indices, SBP, and serum creatinine (Cr) and cystatin C (cysC) to determine estimated glomerular filtration rate (eGFR). We selected Term-matched
Controls
at 10–13 years from the 2015–2016 NHANES database at a ratio of 2
Controls
:1
Case
(124:62).
Results
Reenrolled patients were predominantly Hispanic, birth weight 1073 ± 251 g, and GA at birth 28 ± 2 weeks. At 10–13 years, 45% were classified overweight/obese, 48% had SBP ≥ 90th centile (77% considered hypertensive), and 34% had low eGFR ( |
| doi_str_mv | 10.1038/s41390-022-02083-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2658232821</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2658232821</sourcerecordid><originalsourceid>FETCH-LOGICAL-c375t-774215988a09dbdb2e44c281236aa0f6b8d9606aad1f4b608b1cd8fda60d6d943</originalsourceid><addsrcrecordid>eNp9kE1LxDAQhoMo7rr6BzxIwIuXar6apkdZ_IIFPSh4C2mTbrO06Zq0h_57s3ZV8OBhmCE88w55ADjH6BojKm4CwzRHCSIkFhI0GQ_AHKc0PjGWHYI5QhQnNM_FDJyEsEEIs1SwYzCjKROMEDEH7y_GBxt643pY23UNi6brNNx6E8LgDVROQ2-caqAeQzW4sredg9btiN74No6Vcn2AevDWrWFZ20bXMeIUHFWqCeZs3xfg7f7udfmYrJ4fnpa3q6SkWdonWcYITnMhFMp1oQtiGCuJwIRypVDFC6FzjuKsccUKjkSBSy0qrTjSXOeMLsDVlLv13cdgQi9bG0rTNMqZbgiS8FQQSgTBEb38g266wce_RSrjOYvmOIkUmajSdyF4U8mtt63yo8RI7rzLybuM3uWXdznGpYt99FC0Rv-sfIuOAJ2AsN15Mv739j-xn_zLjuE</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2769453062</pqid></control><display><type>article</type><title>Persistent high blood pressure and renal dysfunction in preterm infants during childhood</title><source>MEDLINE</source><source>SpringerLink Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Wickland, Jessica ; Steven Brown, L. ; Blanco, Valerie ; Heyne, Roy ; Turer, Christy ; Rosenfeld, Charles R.</creator><creatorcontrib>Wickland, Jessica ; Steven Brown, L. ; Blanco, Valerie ; Heyne, Roy ; Turer, Christy ; Rosenfeld, Charles R.</creatorcontrib><description>Background
Infants born very preterm (≤32 weeks gestational age, GA) and very-low birth weight (≤1500 g; PT-VLBW) demonstrate high systolic blood pressure (SBP), renal dysfunction, and obesity at 6 months–3 years and in early adulthood. Their parallel measurement and progression during childhood is unclear.
Methods
We reenrolled 62/120 patients originally seen at 1–3 years at 10–13 years and remeasured anthropometric indices, SBP, and serum creatinine (Cr) and cystatin C (cysC) to determine estimated glomerular filtration rate (eGFR). We selected Term-matched
Controls
at 10–13 years from the 2015–2016 NHANES database at a ratio of 2
Controls
:1
Case
(124:62).
Results
Reenrolled patients were predominantly Hispanic, birth weight 1073 ± 251 g, and GA at birth 28 ± 2 weeks. At 10–13 years, 45% were classified overweight/obese, 48% had SBP ≥ 90th centile (77% considered hypertensive), and 34% had low eGFR (<90 mL min
−1
[1.73 m
2
]
−1
). Notably, 57% of reenrolled PT-VLBW
Cases
had low eGFR
cysC
at both 1–3 and 10–13 years,
P
< 0.03. Compared to
Controls
,
Cases
had four times the adjusted odds for having an elevated SBP and low eGFR
Cr
despite similar proportions with overweight/obesity among
Cases
and
Controls
.
Conclusions
PT-VLBW infants seen at 1–3 years exhibit obesity, elevated SBP, and low eGFR in infancy and 10–13 years. Although the small sample size may limit conclusions, pediatricians should consider serial evaluations of PT-VLBW throughout childhood.
Impact
The association between preterm birth and elevated blood pressure, renal dysfunction, and obesity in young adults begins as early as 1 year and persists at 10–13 years of age.
This is the first study reporting serial measurements of blood pressure, renal function, and obesity from infancy to preadolescence in children born very preterm.
Fifty-seven percent of preterm 1–3 year olds have persistent low estimated glomerular filtration rate associated with hypertension at 10–13 years.
Clinicians should consider serial evaluations of blood pressure, renal function, and obesity throughout infancy and childhood in all preterm births.</description><identifier>ISSN: 0031-3998</identifier><identifier>EISSN: 1530-0447</identifier><identifier>DOI: 10.1038/s41390-022-02083-y</identifier><identifier>PMID: 35484228</identifier><language>eng</language><publisher>New York: Nature Publishing Group US</publisher><subject>Adult ; Birth weight ; Blood pressure ; Blood Pressure - physiology ; Child ; Child, Preschool ; Childhood ; Clinical Research Article ; Female ; Glomerular Filtration Rate ; Humans ; Hypertension ; Infant ; Infant, Newborn ; Infant, Premature ; Kidney ; Kidney Diseases ; Medicine ; Medicine & Public Health ; Nutrition Surveys ; Obesity ; Overweight ; Pediatric Surgery ; Pediatrics ; Premature Birth ; Young adults</subject><ispartof>Pediatric research, 2023-01, Vol.93 (1), p.217-225</ispartof><rights>The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2022</rights><rights>2022. The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc.</rights><rights>The Author(s), under exclusive licence to the International Pediatric Research Foundation, Inc 2022.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c375t-774215988a09dbdb2e44c281236aa0f6b8d9606aad1f4b608b1cd8fda60d6d943</citedby><cites>FETCH-LOGICAL-c375t-774215988a09dbdb2e44c281236aa0f6b8d9606aad1f4b608b1cd8fda60d6d943</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1038/s41390-022-02083-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1038/s41390-022-02083-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35484228$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wickland, Jessica</creatorcontrib><creatorcontrib>Steven Brown, L.</creatorcontrib><creatorcontrib>Blanco, Valerie</creatorcontrib><creatorcontrib>Heyne, Roy</creatorcontrib><creatorcontrib>Turer, Christy</creatorcontrib><creatorcontrib>Rosenfeld, Charles R.</creatorcontrib><title>Persistent high blood pressure and renal dysfunction in preterm infants during childhood</title><title>Pediatric research</title><addtitle>Pediatr Res</addtitle><addtitle>Pediatr Res</addtitle><description>Background
Infants born very preterm (≤32 weeks gestational age, GA) and very-low birth weight (≤1500 g; PT-VLBW) demonstrate high systolic blood pressure (SBP), renal dysfunction, and obesity at 6 months–3 years and in early adulthood. Their parallel measurement and progression during childhood is unclear.
Methods
We reenrolled 62/120 patients originally seen at 1–3 years at 10–13 years and remeasured anthropometric indices, SBP, and serum creatinine (Cr) and cystatin C (cysC) to determine estimated glomerular filtration rate (eGFR). We selected Term-matched
Controls
at 10–13 years from the 2015–2016 NHANES database at a ratio of 2
Controls
:1
Case
(124:62).
Results
Reenrolled patients were predominantly Hispanic, birth weight 1073 ± 251 g, and GA at birth 28 ± 2 weeks. At 10–13 years, 45% were classified overweight/obese, 48% had SBP ≥ 90th centile (77% considered hypertensive), and 34% had low eGFR (<90 mL min
−1
[1.73 m
2
]
−1
). Notably, 57% of reenrolled PT-VLBW
Cases
had low eGFR
cysC
at both 1–3 and 10–13 years,
P
< 0.03. Compared to
Controls
,
Cases
had four times the adjusted odds for having an elevated SBP and low eGFR
Cr
despite similar proportions with overweight/obesity among
Cases
and
Controls
.
Conclusions
PT-VLBW infants seen at 1–3 years exhibit obesity, elevated SBP, and low eGFR in infancy and 10–13 years. Although the small sample size may limit conclusions, pediatricians should consider serial evaluations of PT-VLBW throughout childhood.
Impact
The association between preterm birth and elevated blood pressure, renal dysfunction, and obesity in young adults begins as early as 1 year and persists at 10–13 years of age.
This is the first study reporting serial measurements of blood pressure, renal function, and obesity from infancy to preadolescence in children born very preterm.
Fifty-seven percent of preterm 1–3 year olds have persistent low estimated glomerular filtration rate associated with hypertension at 10–13 years.
Clinicians should consider serial evaluations of blood pressure, renal function, and obesity throughout infancy and childhood in all preterm births.</description><subject>Adult</subject><subject>Birth weight</subject><subject>Blood pressure</subject><subject>Blood Pressure - physiology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Childhood</subject><subject>Clinical Research Article</subject><subject>Female</subject><subject>Glomerular Filtration Rate</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Kidney</subject><subject>Kidney Diseases</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nutrition Surveys</subject><subject>Obesity</subject><subject>Overweight</subject><subject>Pediatric Surgery</subject><subject>Pediatrics</subject><subject>Premature Birth</subject><subject>Young adults</subject><issn>0031-3998</issn><issn>1530-0447</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kE1LxDAQhoMo7rr6BzxIwIuXar6apkdZ_IIFPSh4C2mTbrO06Zq0h_57s3ZV8OBhmCE88w55ADjH6BojKm4CwzRHCSIkFhI0GQ_AHKc0PjGWHYI5QhQnNM_FDJyEsEEIs1SwYzCjKROMEDEH7y_GBxt643pY23UNi6brNNx6E8LgDVROQ2-caqAeQzW4sredg9btiN74No6Vcn2AevDWrWFZ20bXMeIUHFWqCeZs3xfg7f7udfmYrJ4fnpa3q6SkWdonWcYITnMhFMp1oQtiGCuJwIRypVDFC6FzjuKsccUKjkSBSy0qrTjSXOeMLsDVlLv13cdgQi9bG0rTNMqZbgiS8FQQSgTBEb38g266wce_RSrjOYvmOIkUmajSdyF4U8mtt63yo8RI7rzLybuM3uWXdznGpYt99FC0Rv-sfIuOAJ2AsN15Mv739j-xn_zLjuE</recordid><startdate>20230101</startdate><enddate>20230101</enddate><creator>Wickland, Jessica</creator><creator>Steven Brown, L.</creator><creator>Blanco, Valerie</creator><creator>Heyne, Roy</creator><creator>Turer, Christy</creator><creator>Rosenfeld, Charles R.</creator><general>Nature Publishing Group US</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20230101</creationdate><title>Persistent high blood pressure and renal dysfunction in preterm infants during childhood</title><author>Wickland, Jessica ; Steven Brown, L. ; Blanco, Valerie ; Heyne, Roy ; Turer, Christy ; Rosenfeld, Charles R.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c375t-774215988a09dbdb2e44c281236aa0f6b8d9606aad1f4b608b1cd8fda60d6d943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Adult</topic><topic>Birth weight</topic><topic>Blood pressure</topic><topic>Blood Pressure - physiology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Childhood</topic><topic>Clinical Research Article</topic><topic>Female</topic><topic>Glomerular Filtration Rate</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Kidney</topic><topic>Kidney Diseases</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nutrition Surveys</topic><topic>Obesity</topic><topic>Overweight</topic><topic>Pediatric Surgery</topic><topic>Pediatrics</topic><topic>Premature Birth</topic><topic>Young adults</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wickland, Jessica</creatorcontrib><creatorcontrib>Steven Brown, L.</creatorcontrib><creatorcontrib>Blanco, Valerie</creatorcontrib><creatorcontrib>Heyne, Roy</creatorcontrib><creatorcontrib>Turer, Christy</creatorcontrib><creatorcontrib>Rosenfeld, Charles R.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wickland, Jessica</au><au>Steven Brown, L.</au><au>Blanco, Valerie</au><au>Heyne, Roy</au><au>Turer, Christy</au><au>Rosenfeld, Charles R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Persistent high blood pressure and renal dysfunction in preterm infants during childhood</atitle><jtitle>Pediatric research</jtitle><stitle>Pediatr Res</stitle><addtitle>Pediatr Res</addtitle><date>2023-01-01</date><risdate>2023</risdate><volume>93</volume><issue>1</issue><spage>217</spage><epage>225</epage><pages>217-225</pages><issn>0031-3998</issn><eissn>1530-0447</eissn><abstract>Background
Infants born very preterm (≤32 weeks gestational age, GA) and very-low birth weight (≤1500 g; PT-VLBW) demonstrate high systolic blood pressure (SBP), renal dysfunction, and obesity at 6 months–3 years and in early adulthood. Their parallel measurement and progression during childhood is unclear.
Methods
We reenrolled 62/120 patients originally seen at 1–3 years at 10–13 years and remeasured anthropometric indices, SBP, and serum creatinine (Cr) and cystatin C (cysC) to determine estimated glomerular filtration rate (eGFR). We selected Term-matched
Controls
at 10–13 years from the 2015–2016 NHANES database at a ratio of 2
Controls
:1
Case
(124:62).
Results
Reenrolled patients were predominantly Hispanic, birth weight 1073 ± 251 g, and GA at birth 28 ± 2 weeks. At 10–13 years, 45% were classified overweight/obese, 48% had SBP ≥ 90th centile (77% considered hypertensive), and 34% had low eGFR (<90 mL min
−1
[1.73 m
2
]
−1
). Notably, 57% of reenrolled PT-VLBW
Cases
had low eGFR
cysC
at both 1–3 and 10–13 years,
P
< 0.03. Compared to
Controls
,
Cases
had four times the adjusted odds for having an elevated SBP and low eGFR
Cr
despite similar proportions with overweight/obesity among
Cases
and
Controls
.
Conclusions
PT-VLBW infants seen at 1–3 years exhibit obesity, elevated SBP, and low eGFR in infancy and 10–13 years. Although the small sample size may limit conclusions, pediatricians should consider serial evaluations of PT-VLBW throughout childhood.
Impact
The association between preterm birth and elevated blood pressure, renal dysfunction, and obesity in young adults begins as early as 1 year and persists at 10–13 years of age.
This is the first study reporting serial measurements of blood pressure, renal function, and obesity from infancy to preadolescence in children born very preterm.
Fifty-seven percent of preterm 1–3 year olds have persistent low estimated glomerular filtration rate associated with hypertension at 10–13 years.
Clinicians should consider serial evaluations of blood pressure, renal function, and obesity throughout infancy and childhood in all preterm births.</abstract><cop>New York</cop><pub>Nature Publishing Group US</pub><pmid>35484228</pmid><doi>10.1038/s41390-022-02083-y</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0031-3998 |
| ispartof | Pediatric research, 2023-01, Vol.93 (1), p.217-225 |
| issn | 0031-3998 1530-0447 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2658232821 |
| source | MEDLINE; SpringerLink Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adult Birth weight Blood pressure Blood Pressure - physiology Child Child, Preschool Childhood Clinical Research Article Female Glomerular Filtration Rate Humans Hypertension Infant Infant, Newborn Infant, Premature Kidney Kidney Diseases Medicine Medicine & Public Health Nutrition Surveys Obesity Overweight Pediatric Surgery Pediatrics Premature Birth Young adults |
| title | Persistent high blood pressure and renal dysfunction in preterm infants during childhood |
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