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Biomedical subjects

D J Barker

Publications and source records attributed to D J Barker.

At least 127 records · Page 7Linked to original sources
PubMed1994

Maternal nutritional status in pregnancy and blood pressure in childhood.

OBJECTIVE: To examine the relation between indices of maternal nutrition during pregnancy, including haemoglobin concentration, skinfold thickness and body weight, and the child's blood pressure at 10 to 12 years of age. DESIGN: Follow up study of children whose mothers had haemoglobin estimations, weights and skinfold thicknesses recorded during pregnancy. SETTING: Kingston, Jamaica. SUBJECTS: Seventy-seven children whose mothers took part in a prospective study of nutrition during pregnancy in relation to fetal growth. MAIN OUTCOME MEASURE: Blood pressure at 10 to 12 years of age. RESULTS: The child's mean systolic pressure adjusted for current weight rose by 2.6 mmHg (95% CI 0.5-4.6, P = 0.01) for each 1 g/dl fall in the mother's lowest haemoglobin during pregnancy. Mothers with a lower haemoglobin had thinner skinfold thicknesses, especially over the triceps (P = 0.005). In multiple regression analyses, taking account of the child's sex and current weight, there was a strong association between thin maternal triceps skinfold thickness at 15 weeks of gestation and raised blood pressure in the offspring. Taking account of the mother's triceps skinfold thickness abolished the relation between lower haemoglobin and raised blood pressure in the child. Lower weight gain between 15 and 35 weeks of gestation was independently associated with raised children's blood pressure. Systolic pressure rose by 10.7 mmHg (95% CI 5.7 to 15.6, P = 0.0001) for each log mm decrease in the mother's triceps skinfold thickness, and by 0.6 mmHg (95% CI 0.1 to 1.0, P = 0.02) for each 1 kg decrease in the mother's weight gain during pregnancy. CONCLUSIONS: These results parallel animal experiments suggesting that impaired maternal nutrition may underlie the programming of adult hypertension during fetal life.

Blood Pressure↗
PubMed1994

Outcome of low birthweight.

Babies who are small at birth and during infancy are now known to be at an increased risk of developing coronary heart disease, hypertension and diabetes during adult life. This has led to the suggestion that these diseases are 'programmed' by an inadequate supply of nutrients or oxygen in utero or immediately after birth. The phenomenon of 'programming', whereby undernutrition in early life permanently changes body structure and function, is well documented in animals. As yet we know little about cellular and molecular changes which underlie it, but persisting changes in the secretion of hormones or in the sensitivity of tissues to them may be important in determining adult disease.

Adult↗
PubMed1994

The relationship between pneumonia in early childhood and impaired lung function in late adult life.

This study related respiratory illness documented in the first 2 yr of life to the lung function of 618 men and women with a mean age of 70 yr living in Derbyshire, England. Pneumonia before 2 yr of age was associated with a lower mean FEV1, adjusted for age and height. In men, the difference was -0.65L (95% CI: -1.02, -0.29; p = 0.0005). This estimate did not diminish after adjustment for smoking and asthma. In women, the reduction in mean FEV1 associated with pneumonia before 2 yr of age was smaller and nonsignificant. Bronchitis, measles, and whooping cough before 2 yr of age were not associated with diminished adult lung function in either sex. The findings in men support a causal relationship between pneumonia in early childhood and COPD in late adult life.

Age Factors↗
PubMed1994

Reduced fetal growth increases risk of cardiovascular disease.

Follow-up studies of several thousand people who were born in the first half of this century in England and who had been measured and weighed at birth by midwives or health visitors were carried out to investigate how these early measurements were related to the later occurrence of illness and death and to levels of risk factors for ischemic heart disease and stroke. The mortality rate from cardiovascular diseases was higher in people who as babies had been lightweight or short at birth or who had grown poorly during infancy. Levels of blood pressure in adult life were highest in people who had been small at birth. Plasma concentrations of fibrinogen were highest in men who had grown least during the first year of life. These findings suggest that reduced fetal and infant growth is an important determinant of risk of cardiovascular disease in adult life. They have implications for the prevention of cardiovascular disease, and they may help us understand international differences in rates of stroke and the secular trends in stroke mortality.

Adult↗
PubMed1993

Early growth and death from cardiovascular disease in women.

OBJECTIVE: To determine whether the link suggested between growth in utero and during infancy and death from cardiovascular disease in men is also present in women. DESIGN: Follow up study of women and men whose birth weight and weight at 1 year of age had been recorded. SETTING: Hertfordshire, England. SUBJECTS: 5585 women and 10,141 men born during 1911-30. MAIN OUTCOME MEASURES: Standardised mortality ratios for cardiovascular disease. RESULTS: Among women and men death rates from cardiovascular disease fell progressively between the low and high birth weights groups (chi 2 = 4.3, p = 0.04 for women, chi 2 = 8.5, p < 0.005 for men). Cardiovascular deaths in men but not women were also strongly related to weight at 1 year, falling progressively between the low and high weight groups (chi 2 = 27.5, p < 0.0001). The highest cardiovascular death rates in women were among those with below average birth weight but above average weight at 1 year. In men the highest rates were among those with below average birth weight and below average weight at 1 year. CONCLUSION: Relations between cardiovascular disease and birth weight are similar in men and women. In men cardiovascular disease is also related to weight gain in infancy.

Aged↗
PubMed1993

Growth in utero and serum cholesterol concentrations in adult life.

OBJECTIVE: To see whether reduced rates of fetal growth are related to raised serum cholesterol concentrations in adult life. DESIGN: Follow up study of men and women whose size at birth had been recorded. SETTING: Jessop and Northern General Hospitals, Sheffield. SUBJECTS: 219 men and women born in the Jessop Hospital during 1939-40. MAIN OUTCOME MEASURES: Serum concentrations of total cholesterol, low density lipoprotein cholesterol, and apolipoprotein B. RESULTS: Men and women who had had a small abdominal circumference at birth had raised serum concentrations of total and low density lipoprotein cholesterol and apolipoprotein B. This was independent of the duration of gestation. Serum concentrations of total cholesterol fell by 0.25 mmol/l (95% confidence interval 0.09 to 0.42) with each 1 in (2.54 cm) increase in abdominal circumference. The corresponding figure for serum low density lipoprotein cholesterol was 0.26 mmol/l (0.11 to 0.42) and for serum apolipoprotein B 0.04 g/l (0.02 to 0.07). Small head and chest circumferences at birth and short length were each associated with raised serum low density lipoprotein cholesterol concentrations but the trends disappeared in a simultaneous regression with abdominal circumference at birth. The association between abdominal circumference at birth and low density lipoprotein cholesterol concentration was independent of social class, current body weight, cigarette smoking, and alcohol consumption. CONCLUSION: Raised serum cholesterol concentrations in adult life are associated with impaired growth during late gestation, when fetal undernutrition has a disproportionate effect on liver growth. Impaired liver growth may permanently alter low density lipoprotein cholesterol metabolism.

Abdomen↗
PubMed1993

Relation of fingerprints and shape of the palm to fetal growth and adult blood pressure.

OBJECTIVE: To examine how finger and palm prints are related to fetal growth and adult blood pressure. DESIGN: Follow up study of babies born around 50 years ago whose birth weight, placental weight, head circumference, and length at birth were recorded. SETTING: Preston, Lancashire. SUBJECTS: 139 men and women born in Sharoe Green Hospital in Preston during 1935-43 and still living in Lancashire. MAIN OUTCOME MEASURES: Finger and palm prints and current blood pressure. RESULTS: People who were thin at birth had more whorl patterns on their fingers. People who were short at birth in relation to their head circumference had longer hands and a narrower palmer angle. Mean systolic blood pressure was 8 mmHg higher (95% confidence interval 2 to 13; p = 0.01) in the 93 men and women with a whorl pattern on one or more fingers compared with the 46 who had no whorls. The greater the number of fingers with whorls the higher the systolic blood pressure. Whorls on the right hand were more strongly associated with higher systolic pressure than whorls on the left, mean systolic pressure rising by 2.2 mmHg (0.2 to 4.1; p = 0.03) for each additional whorl on the right hand. People with long hands and a narrow palmar angle also had higher systolic pressure. Again, these associations were stronger for the right hand. Mean systolic pressure rose by 0.49 mmHg (-0.03 to 1.01; p = 0.03) for each degree decrease in palmar angle on the right hand. CONCLUSIONS: Fingertip whorls and a narrow palmar angle are indelible markers of impaired fetal development at different stages in pregnancy. Both are associated with raised blood pressure in adult life.

Adolescent↗
PubMed1993

Fetal nutrition and cardiovascular disease in adult life.

Babies who are small at birth or during infancy have increased rates of cardiovascular disease and non-insulin-dependent diabetes as adults. Some of these babies have low birthweights, some are small in relation to the size of their placentas, some are thin at birth, and some are short at birth and fail to gain weight in infancy. This paper shows how fetal undernutrition at different stages of gestation can be linked to these patterns of early growth. The fetuses' adaptations to undernutrition are associated with changes in the concentrations of fetal and placental hormones. Persisting changes in the levels of hormone secretion, and in the sensitivity of tissues to them, may link fetal undernutrition with abnormal structure, function, and disease in adult life.

Adult↗
PubMed1993

The relation of small head circumference and thinness at birth to death from cardiovascular disease in adult life.

OBJECTIVE: To determine how fetal growth is related to death from cardiovascular disease in adult life. DESIGN: A follow up study of men born during 1907-24 whose birth weights, head circumferences, and other body measurements were recorded at birth. SETTING: Sheffield, England. SUBJECTS: 1586 Men born in the Jessop Hospital. MAIN OUTCOME MEASURE: Death from cardiovascular disease. RESULTS: Standardised mortality ratios for cardiovascular disease fell from 119 in men who weighed 5.5 pounds (2495 g) or less at birth to 74 in men who weighed more than 8.5 pounds (3856 g). The fall was significant for premature cardiovascular deaths up to 65 years of age (chi 2 = 5.0, p = 0.02). Standardised mortality ratios also fell with increasing head circumference (chi 2 = 4.6, p = 0.03) and increasing ponderal index (weight/length3) (chi 2 = 3.8, p = 0.05; for premature deaths chi 2 = 6.0, p = 0.01). They were not related to the duration of gestation. Among men for whom the ratio of placental weight to birth weight was in the highest fifths the standardised mortality ratio was 137. CONCLUSION: These findings show that reduced fetal growth is followed by increased mortality from cardiovascular disease. They suggest that reduction in growth begins early in gestation. They are further evidence that cardiovascular disease originates through programming of the body's structure, physiology, and metabolism by the environment during fetal life. Maternal nutrition may have an important influence on programming.

Adult↗
PubMed1993

Initiation of hypertension in utero and its amplification throughout life.

OBJECTIVE: To determine whether the relation between high blood pressure and low birth weight is initiated in utero or during infancy, and whether it changes with age. DESIGN: A longitudinal study of children and three follow up studies of adults. SETTING: Farnborough, Preston, and Hertfordshire, England, and a national sample in Britain. SUBJECTS: 1895 children aged 0-10 years, 3240 men and women aged 36 years, 459 men and women aged 46-54 years, and 1231 men and women aged 59-71 years. The birth weight of all subjects had been recorded. MAIN OUTCOME MEASURE: Systolic blood pressure. RESULTS: At all ages beyond infancy people who had lower birth weight had higher systolic blood pressure. Systolic blood pressure was not related to growth during infancy independently of birth weight. The relation between systolic pressure and birth weight became larger with increasing age so that, after current body mass was allowed for, systolic pressure at ages 64-71 years decreased by 5.2 mm Hg (95% confidence interval 1.8 to 8.6) for every kg increase in birth weight. CONCLUSIONS: Essential hypertension is initiated in fetal life. A raised blood pressure is then amplified from infancy to old age, perhaps by a positive feedback mechanism.

Adult↗
PubMed1993

Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidaemia (syndrome X): relation to reduced fetal growth.

Two follow-up studies were carried out to determine whether lower birthweight is related to the occurrence of syndrome X-Type 2 (non-insulin-dependent) diabetes mellitus, hypertension and hyperlipidaemia. The first study included 407 men born in Hertfordshire, England between 1920 and 1930 whose weights at birth and at 1 year of age had been recorded by health visitors. The second study included 266 men and women born in Preston, UK, between 1935 and 1943 whose size at birth had been measured in detail. The prevalence of syndrome X fell progressively in both men and women, from those who had the lowest to those who had the highest birthweights. Of 64-year-old men whose birthweights were 2.95 kg (6.5 pounds) or less, 22% had syndrome X. Their risk of developing syndrome X was more than 10 times greater than that of men whose birthweights were more than 4.31 kg (9.5 pounds). The association between syndrome X and low birthweight was independent of duration of gestation and of possible confounding variables including cigarette smoking, alcohol consumption and social class currently or at birth. In addition to low birthweight, subjects with syndrome X had small head circumference and low ponderal index at birth, and low weight and below-average dental eruption at 1 year of age. It is concluded that Type 2 diabetes and hypertension have a common origin in sub-optimal development in utero, and that syndrome X should perhaps be re-named "the small-baby syndrome".

Aged↗
PubMed1993

Fetal growth and impaired glucose tolerance in men and women.

A follow-up study was carried out to determine whether reduced fetal growth is associated with the development of impaired glucose tolerance in men and women aged 50 years. Standard oral glucose tolerance tests were carried out on 140 men and 126 women born in Preston (Lancashire, UK) between 1935 and 1943, whose size at birth had been measured in detail. Those subjects found to have impaired glucose tolerance or non-insulin-dependent diabetes mellitus had lower birthweight, a smaller head circumference and were thinner at birth. They also had a higher ratio of placental weight to birthweight. The prevalence of impaired glucose tolerance or diabetes fell from 27% in subjects who weighed 2.50 kg (5.5 pounds) or less at birth to 6% in those who weighed more than 3.41 kg (7.5 pounds) (p < 0.002 after adjusting for body mass index). Plasma glucose concentrations taken at 2-h in the glucose tolerance test fell progressively as birthweight increased (p < 0.004), as did 2-h plasma insulin concentrations (p < 0.001). The trends with birthweight were independent of duration of gestation and must therefore be related to reduced rates of fetal growth. These findings confirm the association between impaired glucose tolerance in adult life and low birthweight previously reported in Hertfordshire (UK), and demonstrate it in women as well as men. It is suggested that the association reflects the long-term effects of reduced growth of the endocrine pancreas and other tissues in utero. This may be a consequence of maternal undernutrition.

Birth Weight↗