Initial Data on the Natural History of apwv in West African Infants

Introduction: Aortic pulse wave velocity (aPWV) may measure vascular structure and function (distensibility) more precisely than blood pressure (BP). Few data exist on arterial distensibility in infancy; none on the effects of malaria in African children. Methods: Healthy women with singleton pregnancies were recruited at Adeoyo Maternity Hospital, Ibadan, Nigeria. Measures of anthropometry, resting BP and aPWV using a Doppler device were taken on mothers and their babies at birth and three months later. Results: 147 mother-baby pairs were measured at birth; 74 mothers had slide-positive malaria. 79 mother-baby pairs were measured at 3 months of age, but only 24 at both times. At birth, mean (SD) aPWV of infants whose mothers had malaria was 4.6 (1.6) m/s and SBP/DBP of 75.0/38.5 mmHg compared with those without 5.6 (1.6) m/s and 72.0/35.8 mmHg. Adjusting for birthweight, these differences were not significant. By 3 months, children with maternal malaria had aPWV & BP of 7.2 (2.8) m/s and 88.2/47.8 mmHg compared to those without at 7.0 (3.0) m/s and 87.6/48.6 mmHg. Neonatal aPWV was significantly related only to heart rate (R=0.40;p<0.001), but at 3 months to heart rate (R=0.27;p=0.015) and maternal age (R=0.25;p=0.028), independent of maternal and infant BP. Discussion: aPWV on average increased during the first three months of life, uncorrelated between birth and 3 months. Children with maternal malaria had slightly lower aPWV at birth, catching up by 3 months. Whether higher aPWV develops sooner in babies with malaria than in those without malaria will be examined in follow-up.