Increased blood pressure but normal renal function in adult women born preterm

It has been suggested that children born small for gestational age may deve lop hypertension and renal dysfunction in adulthood due to impaired fetal k idney development. Very little information on this issue is available on ch ildren born preterm. The objective of this study was to investigate the rel ationship between birth weight, blood pressure, and kidney function in adul t subjects who were born preterm or born small for gestational age (SGA). S tudy design: Subjects (n=50), all women born between 1966 and 1974, were ev aluated at a mean age of 26+/-1.9 years. They were allocated to three group s: (1) born before gestational week 32 (n=15), (2) born full term with birt h weight <2600 g (n=18) (SGA), and (3) controls, born full term with approp riate birth weight (n=17). Casual blood pressure, ambulatory 24-h blood pre ssure (ABPM), glomerular filtration rate (GFR), renal plasma flow (ERPF) an d urinary albumin excretion were determined. Results: Preterms had signific antly higher casual systolic and mean arterial blood pressure levels compar ed to controls (123+/-13 vs 110+/-7 mmHg, P<0.01, and 87+/-9 vs 79+/-6 mmHg , P<0.005, respectively). ABPM was not significantly different between the groups. When the number of systolic recordings >130 mmHg/subject during ABP M was calculated, the preterms had significantly more recordings above this value (P<0.05) as well as a significantly increased area under the curve > 130 mmHg and >140 mmHg systolic (P<0.05) compared to the controls. SGA subj ects were not significantly different from controls. There were no signific ant differences in GFR, ERPF or urinary albumin excretion between the three groups. Conclusion: Women born preterm seem to have a disturbance in blood pressure regulation in adulthood, a finding that is not observed for those born small for gestational age. Kidney function in early adulthood seems t o be normal in subjects born preterm or small for gestational age.