Adult cardiovascular risk factors in premature babies

Abstract

R John Irving and colleagues (June 17, p 2135)1Irving RJ Belton NR Elton RA Walker BR Adult cardiovascular risk factors in premature babies.Lancet. 2000; 355: 2135-2136Summary Full Text Full Text PDF PubMed Scopus (226) Google Scholar show that babies born prematurely, whether they have intrauterine growth retardation (IUGR) or not, are predisposed to similar risks as adults. They state that those with IUGR are not more disadvantaged than those with birthweights appropriate for gestational age.Although this statement may be true, it cannot be substantiated by their study because the two groups of preterm babies (IUGR and appropriate weight for gestational age group) were not comparable. The male/female ratio is roughly equal in the appropriate weight for gestational age group and almost one to three in the IUGR group. Women generally have a better metabolic profile than men and, mainly, higher high-density lipoprotein cholesterol.2Rifkind BM Segel P Lipid Research Clinics program reference values of hyperlipidemia andhypolipidemia.JAMA. 1983; 250: 1869-1872Crossref PubMed Scopus (176) Google Scholar For this reason, differences between the two groups might have been obscured. Gestational age might be another confounding factor. Gestational age at birth was significantly different between the two groups (31·9 vs 35·2 weeks). Irving and colleagues state that longer gestation was associated with lower blood pressure and a better metabolic profile. Babies with IUGR would probably, therefore, be more disadvantaged than those with appropriate weight for gestational age if they have the same gestational age.Finally, although it was found that low-birthweight premature babies had higher adult fasting plasma glucose than normal birthweight controls born at term, these differences were not significant. R John Irving and colleagues (June 17, p 2135)1Irving RJ Belton NR Elton RA Walker BR Adult cardiovascular risk factors in premature babies.Lancet. 2000; 355: 2135-2136Summary Full Text Full Text PDF PubMed Scopus (226) Google Scholar show that babies born prematurely, whether they have intrauterine growth retardation (IUGR) or not, are predisposed to similar risks as adults. They state that those with IUGR are not more disadvantaged than those with birthweights appropriate for gestational age. Although this statement may be true, it cannot be substantiated by their study because the two groups of preterm babies (IUGR and appropriate weight for gestational age group) were not comparable. The male/female ratio is roughly equal in the appropriate weight for gestational age group and almost one to three in the IUGR group. Women generally have a better metabolic profile than men and, mainly, higher high-density lipoprotein cholesterol.2Rifkind BM Segel P Lipid Research Clinics program reference values of hyperlipidemia andhypolipidemia.JAMA. 1983; 250: 1869-1872Crossref PubMed Scopus (176) Google Scholar For this reason, differences between the two groups might have been obscured. Gestational age might be another confounding factor. Gestational age at birth was significantly different between the two groups (31·9 vs 35·2 weeks). Irving and colleagues state that longer gestation was associated with lower blood pressure and a better metabolic profile. Babies with IUGR would probably, therefore, be more disadvantaged than those with appropriate weight for gestational age if they have the same gestational age. Finally, although it was found that low-birthweight premature babies had higher adult fasting plasma glucose than normal birthweight controls born at term, these differences were not significant. DEPARTMENT OF ERROREarly non-invasive management of acute coronary syndromes—In this Correspondence letter by Michele Galli and Diego Ardissino (Sept 9, p 941), the second sentence of the second paragraph, on page 941, should be, “In FRISC II, 830 (68%) of the participants had left main or involvement of the left anterior descending coronary artery, and in previous trials medical treatment has been less effective than coronary surgery in preventing major cardiac events and improving symptoms in such patients, especially in the presence of left-ventricular dysfunction”. Full-Text PDF DEPARTMENT OF ERRORSelenium and human health—In this Correspondence letter by S Wamique Yusuf (Sept 9, p 943), the sixth sentence of the second paragraph, on page 944, should be, “In the USA and Japan, widely used trace element preparations contain no selenium”. Full-Text PDF Adult cardiovascular risk factors in premature babiesAuthors' reply Full-Text PDF