| Autor: |
Amaral MS; From the Public Health Department (M.S.A., C.C.C.R., M.T.S.d.B.e.A., J.X.P.T.N., V.M.F.S., A.A.M.d.S.), Federal University of Maranhão, São Luís, Brazil., Ribeiro CCC; From the Public Health Department (M.S.A., C.C.C.R., M.T.S.d.B.e.A., J.X.P.T.N., V.M.F.S., A.A.M.d.S.), Federal University of Maranhão, São Luís, Brazil.; Dentistry Department (C.C.C.R.), Federal University of Maranhão, São Luís, Brazil., Alves MTSBE; From the Public Health Department (M.S.A., C.C.C.R., M.T.S.d.B.e.A., J.X.P.T.N., V.M.F.S., A.A.M.d.S.), Federal University of Maranhão, São Luís, Brazil., Ribeiro MJS; Ceuma University, São Luís, Maranhão, Brazil (M.J.S.R.)., Nascimento JXPT; From the Public Health Department (M.S.A., C.C.C.R., M.T.S.d.B.e.A., J.X.P.T.N., V.M.F.S., A.A.M.d.S.), Federal University of Maranhão, São Luís, Brazil., Simões VMF; From the Public Health Department (M.S.A., C.C.C.R., M.T.S.d.B.e.A., J.X.P.T.N., V.M.F.S., A.A.M.d.S.), Federal University of Maranhão, São Luís, Brazil., Ferraro AA; Department of Pediatrics, University of São Paulo School of Medicine, University of São Paulo, Brazil (A.A.F.)., Barbieri MA; Faculty of Medicine of Ribeirão Preto, São Paulo University, Department of Puericulture and Pediatrics, Ribeirão Preto, Brazil (M.A.B.)., Silva AAMD; From the Public Health Department (M.S.A., C.C.C.R., M.T.S.d.B.e.A., J.X.P.T.N., V.M.F.S., A.A.M.d.S.), Federal University of Maranhão, São Luís, Brazil. |
| Abstrakt: |
Risk factors act around birth increasing future vascular risk. In this study, we analysed the pathways from perinatal factors to the vascular risk phenotype (VRP) in adolescents including indirect pathways mediated by obesity in adolescence. Data from a Brazilian cohort were collected at birth and at 18 to 19 years (follow-up). A theoretical model was constructed to analyze the association between variables at birth (socioeconomic status, prepregnancy body mass index, mother's age, history of maternal hypertension, maternal smoking, gestational age at birth, birth weight, sex, delivery type) and at follow-up (smoking and excess weight) with the VRP, using structural equation modeling. VRP was a continuous latent variable, representing the shared variance of blood pressure indictors and carotid-femoral pulse wave velocity. Males had higher VRP (standardized coefficient [SC], 0.561; P< 0.001). Higher prepregnancy body mass index was associated with higher VRP (SC, 0.140; P =0.032). Gestational age <34 weeks had a total (SC, 0.259; P =0.002) and direct effect (SC, 0.354; P =0.018) on VRP. Cesarean delivery had a total effect, albeit borderline, on VRP (SC, 0.159; P =0.066). Excess weight at follow-up was the main determinant of a high VRP (SC, 0.470; P< 0.001). Male sex, cesarean section, gestational age <34 weeks, pregestational excess weight, and excess weight in adolescents were associated with increased VRP at 18 to 19 years of age. |
