Abstract
(1) Background: Preterm-born children have an increased cardiovascular risk with the first clinical manifestation during childhood and/or adolescence. (2) Methods: The occurrence of overweight/obesity, prehypertension/hypertension, valve problems or heart defects, and postnatal microRNA expression profiles were examined in preterm-born children at the age of 3 to 11 years descending from preterm prelabor rupture of membranes (PPROM) and spontaneous preterm birth (PTB) pregnancies. The whole peripheral blood gene expression of 29 selected microRNAs associated with cardiovascular diseases was the subject of our interest. (3) Results: Nearly one-third of preterm-born children (32.43%) had valve problems and/or heart defects. The occurrence of systolic and diastolic prehypertension/hypertension was also inconsiderable in a group of preterm-born children (27.03% and 18.92%). The vast majority of children descending from either PPROM (85.45%) or PTB pregnancies (85.71%) had also significantly altered microRNA expression profiles at 90.0% specificity. (4) Conclusions: Postnatal microRNA expression profiles were significantly influenced by antenatal and early postnatal factors (gestational age at delivery, birth weight of newborns, and condition of newborns at the moment of birth). These findings may contribute to the explanation of increased cardiovascular risk in preterm-born children. These findings strongly support the belief that preterm-born children should be dispensarized for a long time to have access to specialized medical care.
Highlights
Preterm-born children have an increased cardiovascular risk, with the first clinical manifestation during childhood and/or adolescence
These findings strongly support the belief that preterm-born children should be dispensarized for a long time to have access to specialized medical care
The groups of children with abnormal clinical findings consisted of those already dispensarized in the Department of Pediatric Cardiology; those indicated, by the sonographer during a visit to our department, to have valve problems and/or heart defects; those confirmed, over several visits to our department, to have either systolic prehypertension/hypertension and/or diastolic prehypertension/hypertension; and/or those who were diagnosed to be overweight/obese (NP, n = 39/92; preterm birth, n = 66/111)
Summary
Preterm-born children have an increased cardiovascular risk, with the first clinical manifestation during childhood and/or adolescence. Multiple risk factors predisposing to a later development of cardiovascular diseases have been identified in preterm-born individuals These risk factors involve increased peripheral and central systolic (SBP) and/or diastolic (DBP) blood pressures [1,2,3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21], higher heart rate (HR) [4,22,23], higher fat mass [21], lower functional skin capillary density [4], lower peripheral skin blood flow [24], abnormal retinal vascularization (both structure and function) [1,3,17], increased sympathoadrenal activity together with higher levels of urine catecholamines [22], kidney hypoplasia, incomplete nephrogenesis (reduced number of nephrons) and impaired renal function (decreased glomerular filtration rate, microalbuminuria) [20,25,26,27,28], worsened respiratory parameters usually as a consequence of bronchopulmonary dysplasia (BPD) [19,29,30], impaired exercise capacity [19,30], elevated fasting glucose and cholesterol levels [10], higher serum levels of insulin 2 h after the Biomedicines 2021, 9, 727. Lower left ventricular longitudinal shortening and systolic tissue velocity [12], higher transversal shortening fraction [12], lower atrial emptying velocities [12], higher right ventricular myocardial performance index (RVmpi’) [51], elevated aortic wave reflection [14], decreased carotid and brachial distensibility [18], and higher estimated pulmonary vascular resistance (PVR) [51] were found in children, adolescents, and young preterm-born adults
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