Prematurity and Low Birth Weight Associate with Adolescent Hypertension in a Large Nationwide Cohort

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Background: prematurity is a global burden occuring in ˜ 11% of total deliveries. Chronic kidney disease (CKD), due to incomplete nephrogenesis and acute kidney injury episodes, can be a long term complication of prematurity. The aim of this study is to explore the risk of having hypertension or proteinuria, as CKD manifestations, in adolescents born prematurely or small for gestational age in a large nationwide cohort. Methods: Study population included potential recruits that were examined in an Israel Defence Forces (IDF) medical facility between November 2005 and October 2018. Clinical, demographic and anthropometric data were retrieved from the IDF medical files electronic system. Data regarding gestational age at delivery, retrieved from the Israeli Ministry of Health database, was available for adolescents born between January 1993 to December 2000. Results: Study cohort included 513,802 participants, aged 17.3±0.9 years. 48,994 individuals had data regarding gestational age at birth (38.8 ± 2.99 weeks). Adolescents born as very- and extremely preterm infants had 55% and 47% greater risk for having hypertension, respectively. Being born with very or extremely low birth weights have an OR of 1.19 and 1.12 for adolescent hypertension, respectively (figure 1). Within the overweight and obese adolescents, comparison between different birth weight groups revealed higher hypertension prevalence in adolescents born as low, very low and extremely low birth weights (figure 2). Conclusions: Our study demonstrated a higher trend for adolescent hypertension in very premature infants and in infants born with very and extremely low birth weight. These adolescents should be monitored for signs of CKD in order to treat and delay its progression.

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