Blood pressure is related to placental volume and birth weight

The objective of this study was to determine whether maternal nutrition and fetal and placental size program blood pressure. A longitudinal study link ing the maternal anthropometric measurements of the first antenatal visit, ultrasound data of placental and fetal size, anthropometry at birth, and ch ildhood growth and blood pressure was performed. The subjects were 428 wome n who attended the antenatal clinic at the University Hospital of the West Indias, Kingston, Jamaica, and their children, who were subsequently follow ed up. Systolic blood pressure at ages 1, 2, 2.5, 3, and 3.5 years was the main outcome measure. Pooling the data across ages, systolic blood pressure fell by 1.4 mm Hg for every 1-kg increase in birth weight (95% CI 0.2 to 2 .7, P=0.02) and by 1.2 mm Hg for every 100-mL increase in placental volume at 20 weeks of gestation (95% CI 0.4 to 2.0, P=0.004). Blood pressure was a lso negatively associated with placental volume at 17 weeks and fetal abdom inal circumference at 20 weeks. Measures of maternal nutritional status wer e strongly related to birth weight and placental volume but not directly to childhood blood pressure at these young ages. In conclusion, blood pressur e is associated with fetal size in this population, as previously described among Europeans. We found associations between placental volume and abdomi nal circumference in the second trimester and childhood blood pressure, sug gesting that the initiating events of blood pressure programming occur earl y in pregnancy. Measures of maternal nutritional status were not directly r elated to childhood blood pressure at these young ages but were strong pred ictors of both birth weight and placental volume, suggesting an indirect re lation.