This cross-sectional study investigates the relationship between gestational age and systolic blood pressure and pulse pressure in childhood. Blood pressure was measured in 483 schoolchildren, free from cardiovascular disease, aged between 6 and 16 years. Pulse pressure was estimated as the difference between the 24-h mean systolic and diastolic blood pressure values. Linear regression showed an inverse relationship between gestational age and mean 24-h systolic blood pressure (adjusted regression coefficient mm Hg per week gestation -0.631, 95% confidence interval (CI) -1.21 to -0.04, P=0.036). Further, linear regression showed a significant negative association between gestational age and log-transformed pulse pressure (adjusted antilog regression coefficient mm Hg per week of gestation -1.39, 95% CI -2.96 to -0.3, P=0.013), which after gender-specific analyses was found to be restricted to the girls in the study. The results of the present study suggest that low gestational age is associated with elevated systolic blood pressure and pulse pressure in childhood, the latter particularly in girls. This observation provides some support for the developmental origins of adult disease hypothesis-that adverse events in early life may have long-term consequences for cardiovascular health. However, as gestational age itself is unlikely to be the causal event in determining blood pressure control, further investigation is required, particularly with regard to the nutritional, physiological and molecular mechanisms that explain such epidemiological observations.