Abstract
Cardiovascular disease is the leading cause of death worldwide. Evidence points towards an unfavorable cardiovascular risk profile of former preterm infants in adolescence and adulthood. The aim of this study was to determine whether cardiovascular risk predictors are detectable in former very preterm infants at a preschool age. Five- to seven-year-old children born at <32 weeks’ gestational age were included in the study. Same-aged children born at term served as controls. Basic data of study participants were collected by means of follow-up databases and standardized questionnaires. At study visit, anthropometric data, blood pressure readings and aortic intima-media thickness were assessed. Blood samples were obtained after an overnight fast. In comparison to children born at term, former preterm infants had higher systolic and diastolic blood pressure readings (odds ratio [95% confidence interval] per 1-SD higher blood pressure level 3.2 [2.0–5.0], p<0.001 and 1.6 [1.1–1.2], p = 0.008), fasting glucose levels (OR [95% CI] 5.2 [2.7–10.1], p<0.001), homeostasis model assessment index (OR [95% CI] 1.6 [1.0–2.6], p = 0.036), and cholesterol levels (OR [95% CI] 2.1 [1.3–3.4], p = 0.002). Systolic prehypertension (23.7% vs. 2.2%; OR [95% CI] 13.8 [3.1–60.9], p = 0.001), elevated glucose levels (28.6% vs. 5.9%; OR [95% CI] 6.4 [1.4–28.8], p = 0.016), and hypercholesterolemia (77.4% vs. 52.9%; OR [95% CI] 3.0 [1.3–7.1], p = 0.010) were significantly more prevalent in the preterm group. As former very preterm infants display an unfavorable cardiovascular risk profile already at a preschool age, implementation of routine cardiovascular follow-up programs might be warranted.
Highlights
Due to advances in perinatal care, survival rates of infants born preterm have continuously improved during the last decades [1]
As an increasing number of former preterm infants nowadays are reaching adolescence and adulthood without major overt morbidity, research focus has recently shifted towards longerterm implications of premature birth
As early detection of markers of an increased cardiovascular risk is crucial in order to implement effective preventive strategies, the aim of the current study was to evaluate whether former preterm infants show alterations in known major modifiable and additional cardiovascular risk factors already at a preschool age in comparison to same-aged children born at term
Summary
Due to advances in perinatal care, survival rates of infants born preterm have continuously improved during the last decades [1]. With an increasing number of former preterm infants reaching adulthood without major overt morbidity, new health challenges arise [2]. Cardiovascular Risk in Former Very Preterm Infants. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
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