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J Pediatr. 2007 Oct;151(4):399-403. Epub 2007 Aug 23.

Abnormal circadian blood pressure regulation in children born preterm.

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  • 1Division of Pediatric Nephrology, University Hospital for Pediatric and Adolescent Medicine, Hacettepe University, Ankara, Turkey.



To assess a possible relationship between prematurity and casual blood pressure (BP) by means of 24-hour ambulatory BP monitoring (ABPM).


ABPM was performed in 41 children aged 5 to 17 years who were born prematurely with (n = 11) or without intrauterine growth restriction, and in 27 matched children who were born at term with a birth weight appropriate for gestational age.


Although BP did not differ between the preterm group and control subjects during the daytime, nocturnal standardized systolic BP was elevated (P < .05) and a lack of nocturnal decrease was more prevalent in the preterm children compared with the control subjects (73% versus 41%, P = .01). The difference was caused by a marked increase of nighttime systolic BP in the light-for-date children (1.17 +/- 0.61 standard deviation scores; P < .01), although preterm children with appropriate weight (0.33 +/- 1.00) were not different from control subjects (0.09 +/- 0.73). Nighttime BP standard deviation scores were closely correlated with standardized heart rate, compatible with a role of sympathetic hyperactivation.


Subtle abnormalities of BP regulation, indicated by a selective increase of nocturnal systolic BP, are present during childhood in subjects born prematurely, and are prominent in those with intrauterine growth restriction.

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