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The EPICure study: Growth and blood pressure at 6 years of age following extremely preterm birth
  1. Melanie Anne Bracewell (mabracewell{at}doctors.org.uk)
  1. University of Nottingham, United Kingdom
    1. Enid M Hennessy (e.m.hennessy{at}qmul.ac.uk)
    1. Barts and The London, Queen Mary's School of Medicine and Dentistry, United Kingdom
      1. Dieter Wolke (d.wolke{at}warwick.ac.uk)
      1. Univeristy of Warwick, United Kingdom
        1. Neil Marlow (neil.marlow{at}nottingham.ac.uk)
        1. University of Nottingham, United Kingdom

          Abstract

          Background: Preterm children are at risk for reduced growth in early childhood, which may predispose them to later changes in blood pressure. We studied growth and blood pressure (BP) in extremely preterm (EP) children at age 6 years.

          Methods: We evaluated children who were born at 25 completed weeks of gestation or less in the United Kingdom and Ireland in 1995 when they reached early school age. Children underwent standardized assessments, including auxology and sitting blood pressure.

          Results: Of 308 surviving children, 241 (78 percent) were assessed at a median age of 6 years 4 months; 160 full term classmates acted as a comparison group. Compared to classmates, EP children were 1.2 standard deviations (SD) lighter, 0.97SD shorter, BMI was 0.95SD lower and head circumference 1.3SD lower. Compared to 2.5 years of age, EP children showed catch up in terms of weight by 0.37SD, height by 0.42SD and head circumference by 0.13SD. Systolic and diastolic BP were lower by 2.3mmHg and 2.4mmHg respectively in EP children but these differences were accounted for by differences in height and BMI. Maternal smoking in pregnancy was associated with lower BP, children born before 24 weeks had higher systolic and children given postnatal steroids higher diastolic pressures.

          Conclusions: Poor postnatal growth seen after birth and at in the third year persists into school age. Catch up growth reduces some of the early deficit but is least for head growth. Despite serious postnatal growth restriction blood pressure appears similar in both EP and term classmates.

          • blood pressure
          • growth
          • infant, preterm
          • population study

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