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Higher ambulatory blood pressure at 18 years in adolescents born less than 28 weeks gestation in the 1990s compared with term controls

Roberts, Gehana,b,d; Lee, Katherine J.b,d; Cheong, Jeanie L.Y.a,c,d; Doyle, Lex W.a,c,d; for the Victorian Infant Collaborative Study Group

doi: 10.1097/HJH.0000000000000055
ORIGINAL PAPERS: Children and adolescents

Objectives: Adult preterm survivors from the 1980s have higher blood pressure (BP) than term controls. Survival rates of extremely preterm (gestational age < 28 weeks; EP) infants born after 1990 have increased, but whether they still have higher BP than term controls is unknown. This study compared the BP of contemporary EP survivors with term controls in late adolescence.

Methods: All EP adolescents and matched term controls born in 1991–92 in Victoria, Australia, were enrolled in a longitudinal study. At age 18 years, 24-h ambulatory BP was measured. Average BP was compared between EP and term groups, and predictors of BP in EP adolescents were examined.

Results: BP data were obtained from 136 EP patients and 120 controls. EP patients on average had higher systolic, diastolic and mean BP than controls. The mean systolic difference over 24 h was 3.2 mmHg [95% confidence interval (CI) 0.1–6.4], 3.9 mmHg [95% CI 0.7–7.2] when awake, and 2.0 mmHg (95% CI 1.4–5.5) when asleep. Male sex and change in weight SD score from birth to 2 years were predictive of SBP (regression coefficients 6.2 (95% CI 1.8–10.6), P= 0.006) and 2.0 (95% CI 0.2–3.8), P = 0.032), respectively). SBP at age 8 was associated with BP at age 18 years.

Conclusion: Late adolescent EP survivors of the modern era have higher BP compared with term controls. This highlights the importance of long-term cardiovascular surveillance for this increasing group into adulthood.

aPremature Infant Follow-up Program at the Royal Women's Hospital

bDepartment of Paediatrics

cDepartment of Obstetrics and Gynaecology, University of Melbourne

dMurdoch Children Research Institute, Melbourne, Australia

Correspondence to Dr Gehan Roberts, Premature Infant Follow-up Program, Royal Women's Hospital, Flemington Rd, Parkville, VIC, 3052, Australia. Tel: +613 9345 5356; e-mail: gehan.roberts@rch.org.au

Abbreviations: EP, extremely preterm; NICU, neonatal intensive care unit

Received 31 July, 2013

Accepted 17 October, 2013

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins