Abstract
BackgroundAdverse metabolic outcomes later in life have been reported among children or young adults who were born as preterm infants. This study was conducted to examine the impact of very preterm/very low birth weight (VP/VLBW) birth and subsequent growth after hospital discharge on cardiometabolic outcomes such as insulin resistance, fasting glucose, and systolic and diastolic blood pressure (BP) among children at 6–8 years of age.MethodsThis retrospective cohort study included children aged 6–8 years and compared those who were born at < 32 weeks of gestation or weighing < 1,500 g at birth (n = 60) with those born at term (n = 110). Body size, fat mass, BP, glucose, insulin, leptin, adiponectin, and lipid profiles were measured. Weight-for-age z-score changes between discharge and early school-age period were also calculated, and factors associated with BP, fasting glucose, and insulin resistance were analyzed.ResultsChildren who were born VP/VLBW had significantly lower fat masses, higher systolic BP and diastolic BP, and significantly higher values of fasting glucose, insulin, and homeostatic model assessment of insulin resistance (HOMA-IR), compared to children born at term. VP/VLBW was correlated with HOMA-IR and BPs after adjusting for various factors, including fat mass index and weight-for-age z-score changes. Weight-for-age z-score changes were associated with HOMA-IR, but not with BPs.ConclusionsAlthough children aged 6–8 years who were born VP/VLBW showed significantly lower weight and fat mass, they had significantly higher BPs, fasting glucose, HOMA-IR, and leptin levels. The associations of VP/VLBW with cardiometabolic factors were independent of fat mass and weight gain velocity.
Highlights
Adverse metabolic outcomes later in life have been reported among children or young adults who were born as preterm infants
This study aimed to investigate whether there are differences in the cardiometabolic factors such as insulin resistance, fasting glucose, and systolic and diastolic blood pressure (BP) in early school-aged children born prematurely compared to term infants and whether these adverse cardiometabolic findings are associated with adiposity and growth velocity
In comparison to children born at term, children born as very preterm (VP)/ very low birth weight (VLBW) had significantly higher high-density lipoprotein (HDL) cholesterol, fasting glucose, and homeostatic model assessment of insulin resistance (HOMA-IR)
Summary
Adverse metabolic outcomes later in life have been reported among children or young adults who were born as preterm infants. This study was conducted to examine the impact of very preterm/very low birth weight (VP/VLBW) birth and subsequent growth after hospital discharge on cardiometabolic outcomes such as insulin resistance, fasting glucose, and systolic and diastolic blood pressure (BP) among children at 6–8 years of age. Since the term “thrift phenomenon” was coined by Barker and colleagues [5], an association between low birth weight or small for gestational age (SGA) babies and cardiometabolic problems, such as insulin resistance and increased blood pressure (BP), has been consistently demonstrated by many prospective and cohort studies [6,7,8]. The association between preterm birth and cardiometabolic risks at early school age, considering adiposity and growth velocity, has been scarcely studied
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