Baixo peso ao nascimento e hipertensão arterial na infância: estudo epidemiológico de base comunitária

  • Carlos Manuel de Figueiredo Pereira

Abstract

Introdução: Alguns estudos associam o peso ao nascimento com a ocorrência de doenças na vida adulta, designadamente a hipertensão arterial. Contudo, o mecanismo patológico subjacente ao aparecimento dessa doença não se encontra totalmente esclarecido. O objectivo deste estudo visa quantificar a associação entre o peso ao nascimento e a tensão arterial sistólica na infância. Participantes e métodos: Avaliámos uma amostra aleatória 1788 crianças com idades compreendidas entre os seis e os nove anos de idade, matriculados em 14 escolas do primeiro ciclo do ensino básico da cidade do Porto. Um questionário auto-aplicado foi enviado aos pais ou encarregados de educação, 
que o devolveram à escola juntamente com o boletim de saúde infantil. O peso ao nascimento e o tempo de gestação, foram avaliados através da consulta desse boletim. Na escola, a tensão arterial sistólica foi avaliada três vezes consecutivas com recurso a um aparelho digital (Omnromâ), com a criança na posição de sentado, e posteriormente calculada a respectiva média. Considerámos o percentil 90 como ponto de corte para classificar hipertensão. O estatuto sócio-económico foi avaliado a partir da profissão paterna, agrupada em classes de acordo com o Guia Nacional de Profissões.

Resultados: Após ajuste por regressão logística não condicional, os valores mais altos de tensão arterial sistólica (superior ou igual ao percentil 90) associaram-se significativamente com o sexo masculino OR=1,4 (IC95% 1,1-1,8), a idade (sete anos OR=1,3 IC95% 1,0-1,8; oito anos OR=1,9 IC95% 1,4-2,5 e nove anos OR=3,6 IC95% 2,8-4,8), o peso ao nascimento menor que 2500g OR=1,7 (IC95% 1,0-3,2) e o consumo de tabaco pela mãe durante a gravidez OR=1,4 (IC95% 1,0-2,0). Conclusões: Este estudo mostra que as crianças nascidas com baixo peso, apresentam valores mais altos de tensão arterial sistólica. Assume consistência a hipótese proposta por Barker que associa o baixo peso ao nascimento com a ocorrência de hipertensão arterial na vida adulta.

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Published
2016-02-15
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Articles