CV health profiles worse among adults born preterm or with low birth weight vs. controls
Adults who were born extremely preterm or had an extremely low birth weight had worse CV profiles compared with adult controls, according to findings published in Hypertension.
“Young adults born preterm have less favorable cardiovascular health profiles than their term-born peers,” Jeanie L.Y. Cheong, MD, from Neonatal Services at Royal Women’s Hospital and Clinical Sciences at Murdoch Children’s Research Institute, Melbourne, told Healio. “This is especially in the profiles of blood pressure, exercise capacity, abdominal visceral fat and fasting glucose levels.”
Researchers used data from the Victorian Infant Collaborative Study 1991 to 1992 cohort. This prospective longitudinal study included 297 extremely preterm ( 28 weeks’ gestation) or extremely low birth weight (< 1,000 g) survivors and 253 term-born, normal birth weight controls.
At age 25 years, participants’ height, weight and BMI were collected in 165 study subjects (75% men) and 127 controls (54% men). CV health profiles were calculated for each participant for anthropometry, abdominal visceral fat, BP, fasting plasma glucose, insulin, lipids, C-reactive protein, vascular indices, exercise tolerance and smoking status.
Participants born extremely preterm or with extremely low birth weight had less favorable CV health profiles for abdominal visceral fat (OR = 0.56; 95% CI, 0.33-0.96; P = .03), BP (OR = 0.38; 95% CI, 0.23-0.63; P < .001), exercise capacity (OR = 0.37; 95% CI, 0.22-0.63; P < .001), fasting glucose (OR = 0.51; 95% CI, 0.31-0.84; P = .01) and overall (P = .007) compared with controls.
Unfavorable abdominal visceral fat, BP, fasting glucose and favorable exercise capacity were predicted by male sex. Less favorable exercise capacity and visceral fat profiles were predicted through greater increases in weight z scores between 2 and 8 years and 8 and 18 years.
“The associations of earlier variables with less favorable cardiovascular health profiles at 25 years in the [extremely preterm/extremely low birth weight] cohort are similar to those in previous studies, although many studies have not included exercise capacity in their outcomes,” the researchers wrote. “Accelerated growth in childhood and adolescence represents a potential area for intervention to improve cardiovascular health profiles in early adulthood and, hence, reduce the risk of later cardiometabolic complications.”
According to the researchers, unfavorable cardiometabolic health profiles in young adults born extremely preterm or with extremely low birth weight in the era of modern intensive care and the association between later CVD remain unknown.
“Follow-up to later adult years is critical to understand if the less favorable cardiovascular health profiles identified in this study are associated with later cardiovascular disease. Funding bodies should recognize this as a priority. Also, it is important to go back to the neonatal period to understand why young adults born extremely preterm demonstrate these less favorable cardiovascular health profiles,” Cheong said in an interview. “The results of this study should be interpreted in a positive light, in that individuals born extremely preterm should take a proactive role in close health surveillance and adopt healthy lifestyle choices to optimize their cardiovascular health.”
For more information:
Jeanie L.Y. Cheong, MD, can be reached at jeanie.cheong@thewomens.org.au.
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