Associations between prematurity, birth weight and adolescence blood pressure in a nationwide cohort

Introduction Prematurity is associated with incomplete nephrogenesis and an increased incidence of acute kidney injury, that may increase the risk of future kidney disease, including hypertension, proteinuria and reduced glomerular filtration rate.The aim of this study is to evaluate the risk of hypertension or proteinuria in adolescents born prematurely or small for gestational age, in a nationwide cohort. Methods Study cohort included potential recruits examined in the Israel Defence Forces (IDF) medical facilities, between November 2005 and October 2018. Clinical and anthropometric data, including blood pressure (BP) measurement, were retrieved from the IDF medical files. Adolescents born between January 1993 to December 2000 had additional data regarding gestational age at birth, retrieved from the Israeli Ministry of Health database. Results Study cohort included 513,802 participants, aged 17.3±0.9 years, of whom 48,994 had gestational age data. Adolescents born as very- and extremely preterm infants and those born with very- or extremely low birth weights had higher incidence of hypertensive-range BP (55%, 47%, 19% and 12% respectively). No significant association between birth weight (BW) adjusted to gestational age and hypertension was found. Within the overweight and obese adolescents, those born as very low- and extremely low birth weights, had further increased hypertensive-range BP rate. Proteinuria was diagnosed in 0.33% of study cohort, with no significant difference between BW or gestational age categories. Conclusion Adolescents born as very low BW or as significant preterm were associated with high BP, and should be monitored for hypertension development and its potential complications.