Document Detail

Maternal size at birth and the development of hypertension during pregnancy: a test of the Barker hypothesis.
MedLine Citation:
PMID:  10421284     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Whether individuals who were small at birth are at increased risk of developing cardiovascular disease (the Barker hypothesis) is a topic of great controversy. Although an increased risk has been suggested by several reports, the reports have been criticized for being based on ill-defined populations, for the large numbers of subjects who were unavailable for follow-up, and for inadequate control of socioeconomic status. OBJECTIVE: To determine whether a woman's weight and gestational age at birth predict the development of hypertension during her subsequent pregnancies. DESIGN: Prospective observational study. SUBJECTS: Women born in Copenhagen, Denmark, as subjects in the Danish Perinatal Study (1959-1961) were traced through the Danish Population Register. Information was obtained on their pregnancies from 1974 to 1989. MAIN OUTCOME MEASURES: Onset of hypertension in pregnancy, defined by the presence of a systolic blood pressure of 140 mm Hg or greater or a diastolic blood pressure of 90 mm Hg or greater on 2 visits at or after 140 days' gestation. RESULTS: Hypertension developed in 11.3% of the pregnant women who were small for gestational age at birth, compared with 7.2% of the pregnant women who were not small for gestational age at birth (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.1-2.6), and in 9.4% of the pregnancies in women who were preterm at birth, compared with 7.6% of pregnancies in women who were not preterm at birth (OR, 1.3; 95% CI, 0.8-2.0). After adjustment for adult body mass index, smoking, birth order, and hypertension in the subjects' own mothers, the ORs for small-for-gestational-age women and preterm women to develop hypertension during pregnancy were 1.8 (95% CI, 1.1-2.8) and 1.5 (95% CI, 0.96-2.5), respectively. CONCLUSION: These results support the Barker hypothesis, while addressing many of the methodological criticisms of previous investigations.
M A Klebanoff; N J Secher; B R Mednick; C Schulsinger
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Archives of internal medicine     Volume:  159     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  1999 Jul 
Date Detail:
Created Date:  1999-08-05     Completed Date:  1999-08-05     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1607-12     Citation Subset:  AIM; IM    
Division of Epidemiology, Statistics, and Prevention Research, National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD 20892-7510, USA.
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MeSH Terms
Birth Weight*
Body Mass Index
Confounding Factors (Epidemiology)
Hypertension / etiology*,  genetics
Infant, Newborn
Pregnancy Complications, Cardiovascular / etiology*
Risk Factors
Socioeconomic Factors
Grant Support

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