Preterm birth may be a larger risk factor for increased blood pressure than intrauterine growth restriction

Acta Paediatr. 2015 Nov;104(11):1098-103. doi: 10.1111/apa.13095. Epub 2015 Aug 13.


Aim: Very low birthweight (VLBW) and prematurity have been associated with an increased risk of high blood pressure (BP). We compared BP and salivary cortisol responses to a stressful situation between adolescents with a VLBW and controls.

Methods: We compared three groups aged 12-17 years: 30 born VLBW but appropriate for gestational age (AGA) at a mean of 27 weeks, 19 born VLBW but small for gestational age (SGA) at a mean of 31 weeks and 43 term-born AGA controls. Three consecutive BP measurements were performed before a magnetic resonance imaging (MRI) examination. Salivary cortisol and perceived stress were assessed before and after the MRI.

Results: Systolic and diastolic BP decreased significantly for each repeated measurement in the VLBW-SGA group and controls, but remained unchanged in the VLBW-AGA group. The third systolic BP measurement was 9-12 mmHg higher in the VLBW-AGA group than the other groups (p < 0.05). There were no differences in salivary cortisol between the groups, before and after the MRI or between the sexes.

Conclusion: Dynamic BP responses differed between adolescents born VLBW-AGA and the other groups, indicating that extremely preterm birth may be a larger risk factor for increased BP than intrauterine growth restriction.

Keywords: Gender; Hypertension; Intrauterine growth restriction; Preterm; Stress.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Female
  • Fetal Growth Retardation*
  • Humans
  • Hydrocortisone / analysis
  • Hypertension / complications
  • Hypertension / epidemiology*
  • Hypertension / etiology*
  • Hypertension / metabolism
  • Infant, Small for Gestational Age
  • Infant, Very Low Birth Weight
  • Male
  • Premature Birth*
  • Prospective Studies
  • Risk Factors
  • Saliva / chemistry
  • Stress, Psychological / complications
  • Stress, Psychological / metabolism


  • Hydrocortisone