Low birth weight and cardiovascular risk factors at school age.

BACKGROUND: Many epidemiological studies show a strong association between nutritional status at birth and later chronic diseases, particularly cardiovascular diseases. These results seem to confirm fetal programming regarding risk factors and future diseases such as diabetes, hypertension, cardiovascular disease and kidney dysfunction. The aim of the present study is to evaluate, in a group of low-birth-weight (LBW) newborns, the influence of nutritional status at birth on blood pressure and lipid profile at school age.

METHODS: A group of low birth weight newborns (n = 30) and a group with appropriate gestational age (AGA) (n = 26) were prospectively evaluated from birth up to 84 months of age. Nutritional status was evaluated at every observation and blood pressure and lipid profile were measured at 84 months according to international recommendations.

RESULTS: A catch-up growth was observed in the LBW group during the first two years of life, stature at 84 months being similar in both groups (AGA = -0.3 +/- 0.8 Z-score; LBW = -0.4 +/- 1.1 Z-score). When results are grouped according to weight gain between birth and 84 months of life, and taking account of breast-feeding duration, the LBW children show higher values, with significant differences in diastolic blood pressure between groups in those with greater weight gain (AGA = 88.8 +/- 5.8% of 50th percentile; LBW = 101.2 +/- 5.8% of 50th percentile; p < or = 0.01). Regarding lipid profile, no differences were found except for apolipoprotein A, with lower values in the LBW group (LBW = 125.6 +/- 4.1 mg/dl; AGA = 143.4 +/- 24.6 mg/dl; p < or = 0.05).

CONCLUSIONS: Low birth weight newborns are at higher risk of future cardiovascular disease as they show higher blood pressure values compared to those with appropriate nutritional status at birth. These results are more evident in those individuals with greater weight gain, irrespective of breastfeeding duration. All efforts should be directed towards environmental factors that can negatively influence the health and nutritional status of pregnant women in order to reduce the prevalence of LBW newborns.