Flow-mediated dilation in 9- to 11-year-old children: the influence of intrauterine and childhood factors

Circulation. 1997 Oct 7;96(7):2233-8. doi: 10.1161/01.cir.96.7.2233.


Background: Early life factors, particularly size at birth, may influence later risk of cardiovascular disease, but a mechanism for this influence has not been established. We have examined the relation between birth weight and endothelial function (a key event in atherosclerosis) in a population-based study of children, taking into account classic cardiovascular risk factors in childhood.

Methods and results: We studied 333 British children aged 9 to 11 years in whom information on birth weight, maternal factors, and risk factors (including blood pressure, lipid fractions, preload and postload glucose levels, smoking exposure, and socioeconomic status) was available. A noninvasive ultrasound technique was used to assess the ability of the brachial artery to dilate in response to increased blood flow (induced by forearm cuff occlusion and release), an endothelium-dependent response. Birth weight showed a significant, graded, positive association with flow-mediated dilation (0.027 mm/kg; 95% CI, 0.003 to 0.051 mm/kg; P=.02). Childhood cardiovascular risk factors (blood pressure, total and LDL cholesterol, and salivary cotinine level) showed no relation with flow-mediated dilation, but HDL cholesterol level was inversely related (-0.067 mm/mmol; 95% CI, -0.021 to -0.113 mm/mmol; P=.005). The relation between birth weight and flow-mediated dilation was not affected by adjustment for childhood body build, parity, cardiovascular risk factors, social class, or ethnicity.

Conclusions: Low birth weight is associated with impaired endothelial function in childhood, a key early event in atherogenesis. Growth in utero may be associated with long-term changes in vascular function that are manifest by the first decade of life and that may influence the long-term risk of cardiovascular disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Birth Weight*
  • Blood Glucose / metabolism
  • Blood Pressure
  • Brachial Artery / anatomy & histology
  • Brachial Artery / diagnostic imaging
  • Brachial Artery / physiology*
  • Cardiovascular Diseases / epidemiology*
  • Child
  • Cholesterol, LDL / blood
  • England
  • Female
  • Humans
  • Lipids / blood
  • Muscle, Smooth, Vascular / anatomy & histology
  • Muscle, Smooth, Vascular / diagnostic imaging
  • Muscle, Smooth, Vascular / physiology
  • Parity
  • Pregnancy
  • Regional Blood Flow
  • Risk Factors
  • Socioeconomic Factors
  • Tobacco Smoke Pollution
  • Ultrasonography
  • Vasodilation*


  • Blood Glucose
  • Cholesterol, LDL
  • Lipids
  • Tobacco Smoke Pollution