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 (012 and 036 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 012 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 036 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 012 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 036 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.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology