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Do gastrointestinal tract infections in infancy increase blood pressure in childhood? A cohort study
  1. R M Martin1,2,
  2. M S Kramer3,4,
  3. M Dahhou3,
  4. R W Platt3,4,
  5. R Patel1,
  6. N Bogdanovich5,
  7. L Matush5,
  8. G Davey Smith1,2,
  9. Promotion of Breastfeeding Intervention Trial (PROBIT) Study Group
  1. 1Department of Social Medicine, University of Bristol, Bristol, UK
  2. 2MRC Centre for Causal Analyses in Translational Epidemiology, Department of Social Medicine, University of Bristol, Bristol, UK
  3. 3Department of Pediatrics, McGill University Faculty of Medicine, Montreal, Quebec, Canada
  4. 4Department Epidemiology and Biostatistics, McGill University Faculty of Medicine, Montreal, Quebec, Canada
  5. 5The National Research and Applied Medicine Mother and Child Centre, Minsk, Republic of Belarus
  1. Correspondence to Professor Richard M Martin, Department of Social Medicine, University of Bristol, 39 Whatley Road, Bristol BS8 2PS, UK; richard.martin{at}bristol.ac.uk

Abstract

Background It has been hypothesised that dehydration in infancy could permanently increase sodium retention, raising blood pressure in later life. In this study, the association between gastrointestinal tract infection in infancy, a clinically relevant exposure often accompanied by dehydration, and raised blood pressure in childhood was investigated.

Methods Data from a cohort study nested within a cluster-randomised trial of breastfeeding promotion in the Republic of Belarus were analysed. 17 046 healthy breastfed infants were enrolled from 31 maternity hospitals. 13 889 (81.5%) children were followed-up at 6.5 years. Exposure measures were any gastrointestinal infection in infancy (to 1 year) and hospitalisations for gastrointestinal infection in infancy and in childhood (1–6.5 years). The outcomes were systolic and diastolic blood pressure at age 6.5 years.

Results The prevalence of any gastrointestinal infection in infancy, and of hospitalisation for gastrointestinal infection in infancy or childhood, was 11.4%, 3.2% and 6.0%, respectively. No associations were observed between systolic blood pressure and any gastrointestinal infection (mean difference in those with minus those without infection −0.04 mm Hg; 95% CI −0.52 to 0.43) or hospitalisation for gastrointestinal infection (difference=−0.22 mm Hg; −1.07 to 0.64) in infancy. Nor were associations observed between diastolic blood pressure and any gastrointestinal infection during infancy or hospitalisation for gastrointestinal infection during infancy or childhood.

Conclusion No evidence was found to prove that hospitalisation for gastrointestinal infection in infancy or childhood leads to raised blood pressure at age 6.5 years in a developed country setting.

  • Gastrointestinal infection
  • dehydration
  • sodium retention
  • blood pressure
  • developmental plasticity
  • aetiology outcome
  • blood pressure
  • children
  • cohort ME
  • diarrhoea
  • Accepted 28 October 2009

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Footnotes

  • Funding This study was supported by a grant from the Canadian Institutes of Health Research and by grant no. FOOD-DT-2005-007036 from the European Union's project on Early Nutrition Programming: Long-Term Efficacy and Safety Trials (to RMM and GDS).

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the institutional review board of Montreal Children's Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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