Early childhood blood pressure trajectories in very low birth weight offspring - is there a legacy of maternal hypertension?

Q: What is the objective of the study?

To investigate whether maternal hypertensive disorders of pregnancy are associated with blood pressure in preterm children with very low birth weight.

Q: How were blood pressure trajectories analyzed?

The study used repeated measures of systolic and diastolic BP and age-, height-, and sex-adjusted percentiles, applying linear quantile mixed models across the 25th, 50th, and 75th quantiles, stratified by maternal HDP exposure.

Q: Did maternal HDP significantly affect offspring blood pressure?

Maternal HDP was not significantly associated with systolic or diastolic blood pressure at any quantile.

Q: What trend did blood pressure show over time in this cohort?

Blood pressure increased modestly with age across quantiles, while systolic and diastolic BP percentiles declined over time, with a more pronounced decline for diastolic percentiles, especially in lower quantiles.

Sep 30, 2026

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Objective: investigate the association between maternal hypertensive disorders of pregnancy (HDP) and blood pressure (BP) in preterm children born with very low birth weight (VLBW, <1500 g). Methods: longitudinal cohort of VLBW preterm infants from birth to early childhood; repeated systolic/diastolic BP and age-, height-, and sex-adjusted percentiles analyzed with linear quantile mixed models across 25th, 50th, and 75th quantiles stratified by maternal HDP exposure. Results: 277 infants (43.6% exposed) showed no significant HDP association with BP at any quantile; BP increased modestly with age, while BP percentiles declined. Conclusion: maternal HDP related at most modest, non-significant BP differences, suggesting delayed or subtle cardiovascular effects.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Objective

Methods

Study design

Study population

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Conclusion

Jornal de Pediatria 2026;102(1): 101482 [www.jped.com.br](www.jped.com.br) ORIGINAL ARTICLE Early childhood blood pressure trajectories in very low birth weight offspring: is there a legacy of maternal hypertension? Daiane de Oliveira Pereira Vergani a,b, Jos Mauro Madi a,b,c, Lucas Girotto de Aguiar b, Vitria Rovatti Canello b, Thiago Crocoli Balbinot b, Letícia Lorenzet b, Luciano da Silva Selistre a,b,c, Vandra Carla de Souza a,b,c,* a Universidade de Caxias do Sul, Programa de Ps-Graduac¸~ao em Ci^encias da Sade, Caxias do Sul, RS, Brazil b Universidade de Caxias do Sul, rea do Conhecimento de Ci^encias da Vida, Caxias do Sul, RS, Brazil c Hospital Geral de Caxias do Sul, Caxias do Sul, RS, Brazil Received 3 August 2025; accepted 17 November 2025 Available online xxx KEYWORDS Hypertensive disorders of pregnancy; Blood pressure; Preeclampsia; Preterm birth; Very low birth weight; Offspring Abstract Objective: To investigate the association between maternal hypertensive disorders of pregnancy (HDP) and blood pressure (BP) in preterm children born with very low birth weight (VLBW,< 1500 g) . Methods: Longitudinal cohort study of VLBW preterm infants from birth to early childhood. Systolic and diastolic blood pressure (SBP and DBP), and their age-, height- and sex-adjusted percentiles (SBP%, DBP%), were assessed at multiple time points. Linear quantile mixed models estimated BP trajectories across the 25th, 50th, and 75th quantiles, stratiﬁed by maternal HDP exposure. Results: Among 277 infants, 121 (43.6 %) were exposed to HDP. Median gestational age was 30 weeks (IQR: 28 - 32), and median birth weight was 1180 g (IQR: 985, 1340), 128 (46.2 %) were male. Maternal HDP was not signiﬁcantly associated with SBP or DBP at any quantile. BP increased modestly with age across all quantiles. SBP increased by 0.06, 1.55, and 2.58 mmHg; DBP by 1.77, 1.80, and 3.06 mmHg at the 25th, 50th, and 75th quantiles, respectively. Conversely, SBP% and DBP% declined with age, indicating a relative downward shift in BP percentiles over time. This decline was more pronounced for DBP%, especially in the lower quantiles. Conclusion: In this cohort of VLBW preterm children, maternal HDP was associated with modest differences in blood pressure, though not statistically signiﬁcant. These ﬁndings suggest that the cardiovascular effects of prenatal hypertensive exposure may be delayed, subtle, or modulated * Corresponding author at: Universidade de Caxias do Sul, Programa de Ps-Graduac¸~ao em Ci^encias da Sade, Caxias do Sul, RS, Brazil. [E-mail:](E-mail: vandreasouza@gmail.com)[ vandreasouza@gmail.com](E-mail: vandreasouza@gmail.com) (V.C. de Souza). [https://doi.org/10.1016/j.jped.2025.101482](https://doi.org/10.1016/j.jped.2025.101482) 0021-7557/© 2025 The Authors. Published by Elsevier España, S.L.U. on behalf of Sociedade Brasileira de Pediatria. This is an open access article under the CC BY license ([http://creativecommons.org/licenses/by/4.0/](http://creativecommons.org/licenses/by/4.0/)). Introduction by postnatal factors. Long-term follow-up is essential to clarify these trajectories and guide early prevention efforts. © 2025 The Authors. Published by Elsevier España, S.L.U. on behalf of Sociedade Brasileira de Pediatria. This is an open access article under the CC BY license ([http://creativecommons.org/](http://creativecommons.org/)[ ](http://creativecommons.org/)[licenses/by/4.0/](licenses/by/4.0/) ) . CeClin-UCS preterm outpatient clinic, discharged from two public hospitals. The sample was divided by maternal HDP Hypertension during childhood has emerged as an early marker of future cardiovascular and renal disease, contributing to an increased lifetime morbidity and mortality risk [1] . Children born preterm or with very low birth weight (VLBW) are especially vulnerable, due to impaired nephrogenesis, altered vascular development, and heightened susceptibility to early-onset hypertensi

FAQs

What is the objective of the study?

To investigate whether maternal hypertensive disorders of pregnancy are associated with blood pressure in preterm children with very low birth weight.

How were blood pressure trajectories analyzed?

The study used repeated measures of systolic and diastolic BP and age-, height-, and sex-adjusted percentiles, applying linear quantile mixed models across the 25th, 50th, and 75th quantiles, stratified by maternal HDP exposure.

Did maternal HDP significantly affect offspring blood pressure?

Maternal HDP was not significantly associated with systolic or diastolic blood pressure at any quantile.

What trend did blood pressure show over time in this cohort?

Blood pressure increased modestly with age across quantiles, while systolic and diastolic BP percentiles declined over time, with a more pronounced decline for diastolic percentiles, especially in lower quantiles.

Sep 30, 2026

Upload by Aurelia