ESPE Abstracts (2014) 82 P-D-2-3-500

The Contribution of Maternal Malaria Exposure and Metabolic Markers to Change in Blood Pressure in Nigerian Children over the First 3 Years of Life

Jasmin Farikullah-Mirzaa, Andrew Whatmorea, Omolola Ayoolaa, Olayemi Omotadeb, Imogen Butchera, Handrean Soranc, Kennedy Cruickshankd & Peter Claytona

aCentre for Paediatrics and Child Health, Royal Manchester Children’s Hospital, University of Manchester, Manchester, UK; bCollege of Medicine, University of Ibadan, Ibadan, Nigeria; cCardiovascular Research Group, University of Manchester, Manchester, UK; dCardiovascular Medicine Group, Diabetes and Nutrition Division, King’s College, London, UK

Background: In Nigeria, where malaria is endemic, hypertension is common. We reported that exposure to maternal malaria resulted in smaller babies with lower BP at birth, but a greater change (Δ) in BP to 12 months of age.

Objective and hypotheses: To now present BP measurements out to 3 years of age.

Method: Height, weight, and blood pressure (BP) were measured on 164 babies (75 males and 89 females) at birth, 12, 24, and 36 months. Blood samples collected at 12 months were analysed for IGFI, lipids (triglyceride, HDLc, and LDLc), insulin, adiponectin, and leptin. The effect of malaria on BP and ΔBP (0–12 and 0–36 months) was compared by T-tests. Backward regression analysis was used to assess the association of malarial exposure, sex and biochemical markers on changes in BP over time (P>0.1 to exclude variables).

Results: ΔsBP over 0–12 months was higher in babies exposed to maternal malaria (no malaria 14±17 vs malaria 19±14 mmHg; P=0.03) and this effect persisted to 36 months (18±15 vs 25±13 mmHg; P=0.002). ΔsBP over 0–36 months was lower in females (Δ20 mmHg) than males (Δ23 mmHg) but the impact of malaria was more pronounced in females (+8.7 mmHg with malaria; P=0.003) than males (+5.0 mmHg; P=0.15). ΔsBP over 0–12 months was associated positively with malarial exposure (β=+5.3; P=0.05) and HDLc (+7.9; 0.08) and negatively with leptin (−0.09; 0.008) and LDLc (−0.45; 0.009) (r2=16%). ΔsBP over 0–36 months was associated positively with malarial exposure (β=+8.1; P=0.001) and IGFI (+0.1; 0.029) and negatively with leptin (−0.1; 0.003), LDLc (−2.9; 0.06) and being female (−5.4 (m:f); 0.038) (r2=20%).

Conclusion: Changes in systolic BP over time are greater in children exposed to maternal malaria than those who are not, an effect that is more pronounced in females than males. This increased change in sBP is also independently associated with lower leptin and LDLc levels.