BMJ 1997;315:449-453 (23 August)

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Size at birth, maternal nutritional status in pregnancy, and blood pressure at age 17: population based analysis

Arie Laor, lecturer,a David K Stevenson, professor,b Jeoshua Shemer, senior lecturer,c Rena Gale, associate professor,d Daniel S Seidman, senior physician e

a Department of Internal Medicine, Carmel Hospital, Haifa, Israel, b Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA, c Department of Internal Medicine, Sheba Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel-Hashomer, Israel, d Department of Neonatology, Bikur Cholim Hospital, Jerusalem, Israel, e Department of Obstetrics and Gynecology, Sheba Medical Center

Correspondence to: Dr Seidman

Objective: To assess the effect of size at birth, maternal nutrition, and body mass index on blood pressure in late adolescence.
Design: Population based analysis of birth weight corrected for gestational age, mother's weight before pregnancy and weight gain in pregnancy, obtained from the Jerusalem perinatal study, and blood pressure and body mass index at age 17, available from military draft records.
Setting: Jerusalem, Israel.
Subjects: 10 883 subjects (6684 men and 4199 women) born in Jerusalem during 1974-6 and subsequently drafted to the army.
Main outcome measures: Systolic and diastolic blood pressures measured at age 17 and their correlation with birth weight, size at birth, mother's body mass index and weight gain during pregnancy, and height and weight at age 17.
Results: Systolic and diastolic blood pressures were significantly and positively correlated with body weight, height, body mass index at age 17, and with mother's body weight and body mass index before pregnancy, but not with birth weight or mother's weight gain in pregnancy.
Conclusion: Variables reflecting poor intrauterine nutrition, including low maternal body mass index before pregnancy, poor maternal weight gain in pregnancy, and being born small for gestational age, were not associated with a higher blood pressure in late adolescence.

Key messages

  • Several studies have shown a significant inverse relation between blood pressure and birth weight, though the finding is not consistent

  • In 10 883 Israelis blood pressure measured at age 17 was related to their birth weight adjusted for gestational age, their current body mass index, and their mother's weight before pregnancy and weight gain during pregnancy

  • Blood pressure was significantly and positively correlated with body mass index at age 17 and with mother's weight before pregnancy but not with birth weight or mother's weight gain during pregnancy

  • Variables reflecting poor intrauterine nutrition were therefore not associated with higher blood pressures in late adolescence


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