DOI: 10.1093/aje/kwg130 Blood Pressure in Relation to Birth Weight in Twins and Singleton Controls Matched for Gestational Age

Associations between adult blood pressure and birth weight were investigated in 122 same-sex twin pairs aged 18–50 years and 86 singleton controls matched according to maternal age and parity, gender, gestational age, and current age who were recruited via an obstetric database in Aberdeen, Scotland, in 1999. Twins weighed on average 425 g less than controls at birth (p < 0.001) but did not differ significantly in adult height or systolic or diastolic blood pressure from the controls. Among controls, the differences in systolic and diastolic blood pressure per kg of difference in birth weight, adjusted for gender, gestational age, current age, body mass index, smoking, physical activity level, and alcohol intake, were –4.3 (95 % confidence interval (CI): –12.8, 4.3) and –6.1 (95 % CI: –10.8, –1.5) mmHg/kg, respectively. In unpaired analysis among all twins, the equivalent values were –0.1 (95% CI: –4.0, 3.8) mmHg/kg for systolic pressure and –0.4 (95 % CI: –2.9, 2.2) mmHg/kg for diastolic pressure, while in within-pair analysis the values were –0.9 (95 % CI: –6.4, 4.6) mmHg/kg for systolic pressure and –0.2 (95 % CI: –4.1, 3.7) mmHg/kg for diastolic pressure. The results suggest that in-utero growth restriction in twins is not a major determinant of their blood pressure as adults. birth weight; blood pressure; twins The “fetal origins ” or “programming ” hypothesis proposed by Barker et al. (1) suggests that poor intrauterin