All ETDs from UAB

Advisory Committee Chair

Marti Rice

Advisory Committee Members

Ira Adams-Chapman

Olivia Affuso

Andres Azuero

Charles Downs

Anne Turner-Henson

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) School of Nursing


Little is known about how weight gain in those born very preterm is associated with blood pressure and if cortisol, a stress biomarker, plays a mediating role. Also, the influence of infant feeding practices on weight gain has been only sporadically addressed. The purpose of this exploratory, descriptive, cross-sectional study was to examine the relationships between infant feeding practices, weight gain, and blood pressure noting any mediating effect cortisol may have between weight gain and blood pressure in 18-to-24 month old corrected age toddlers born very preterm. A convenience sample of 36 18-to-24 month old corrected age toddlers were enrolled. Over half had elevated diastolic blood pressures. The participants showed slow growth between birth and discharge, however, a majority had caught up with their term counterparts. Most had ever been fed human milk, but for three months or less in duration. A slight majority began complementary foods at or after four months corrected age. There were small effect sizes between ever fed human milk, duration of human milk, and primary source of nutrition and conditional weight gain (partial eta squared = 0.020, 0.069, and 0.072, respectively). There were very small effect sizes between the type of formula and timing of complementary foods and conditional weight gain (partial eta squared = 0.018 and 0.003). Finally, there was a small effect size between conditional weight gain and systolic blood pressure (Cohen’s r = 0.158) and a medium effect size between conditional weight gain and diastolic blood pressure (Cohen’s r = 0.308). For every one kilogram increase in conditional weight gain there was an associated one mm Hg increase in systolic and diastolic blood pressure. Mediation with cortisol was not supported. The percentage of elevated blood pressure readings was alarming. Catch-up weight gain in this sample was completed earlier than reported elsewhere. The duration of human milk falls short of recommendations. The age at the introduction of complementary foods was younger than recommended. The moderate effect size between weight gain and diastolic blood pressure suggested that greater than anticipated weight gain may be a driver of elevated blood pressure readings.

Included in

Nursing Commons



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