Abstract
There is some evidence that children born post-term (≥42 weeks of gestation) have metabolic abnormalities that may be associated with an increased risk of adverse health outcomes in adulthood. However, there are no data as to whether adolescents born post-term display alterations in aerobic capacity or cardiovascular function. We studied 48 adolescents (56% males) in Auckland (New Zealand) with a mean age of 14.3 years (SD = 1.7): 25 born post-term and 23 born at term (37–41 weeks of gestation). Assessments included metabolic markers in blood, whole body DXA scans, 24-hour ambulatory blood pressure monitoring, maximal exercise capacity, as well as cardiac MRI scan at rest and during submaximal exercise. Exercise capacity was lower in the post-term than in control participants (44.5 vs 47.8 ml/kgffm/min; p = 0.04). There were no differences in left ventricular volumes at rest and during exercise between groups. The 24-hour ambulatory blood pressure monitoring also showed no differences between the two groups. Being born post-term was associated with reduced exercise capacity, but with no observed differences in central cardiac function. We speculate that the reduction in exercise capacity may be due to changes in the peripheral vascular system.
Highlights
Post-term birth, defined as birth on or after 42 weeks of gestation, has been shown to be associated with an increased risk of morbidity and mortality, both in the short- and long-term[1,2]
Post-term children displayed similar metabolic and body composition abnormalities compared to preterm and small for gestational age (SGA) children with reduced insulin sensitivity, higher fat mass, and higher blood pressure[6,7]
There is currently no information regarding the impact of being born post-term on metabolic and cardiovascular health later in life, during adolescence. This is important considering that a reduction in insulin sensitivity has been shown to impact cardiac function and exercise capacity in young individuals[20]
Summary
Post-term birth, defined as birth on or after 42 weeks of gestation, has been shown to be associated with an increased risk of morbidity and mortality, both in the short- and long-term[1,2]. Previous studies investigating growth and metabolism in children born post-term[6,7] showed a 34% reduction in insulin sensitivity in pre-pubertal children and an increased risk of obesity in adolescence males These abnormalities are similar to those observed in children and adults born preterm or SGA, suggesting post-term children may have similar metabolic sequelae[10,11,12,13]. There is currently no information regarding the impact of being born post-term on metabolic and cardiovascular health later in life, during adolescence This is important considering that a reduction in insulin sensitivity has been shown to impact cardiac function and exercise capacity in young individuals[20]. We aimed to assess whether aerobic capacity and cardiovascular function in healthy adolescents born post-term was altered compared to those born at term
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