Abstract

There are well-established morbidities associated with preterm birth including respiratory, neurocognitive and developmental disorders. However several others have recently emerged that characterise an ‘aged’ phenotype in the preterm infant by term-equivalent age. These include hypertension, insulin resistance and altered body fat distribution. Evidence shows that these morbidities persist into adult life, posing a significant public health concern. In this study, we measured relative telomere length in leukocytes as an indicator of biological ageing in 25 preterm infants at term equivalent age. Comparing our measurements with those from 22 preterm infants sampled at birth and from 31 term-born infants, we tested the hypothesis that by term equivalent age, preterm infants have significantly shorter telomeres (thus suggesting that they are prematurely aged). Our results demonstrate that relative telomere length is highly variable in newborn infants and is significantly negatively correlated with gestational age and birth weight in preterm infants. Further, longitudinal assessment in preterm infants who had telomere length measurements available at both birth and term age (n = 5) suggests that telomere attrition rate is negatively correlated with increasing gestational age. Contrary to our initial hypothesis however, relative telomere length was significantly shortest in the term born control group compared to both preterm groups and longest in the preterm at birth group. In addition, telomere lengths were not significantly different between preterm infants sampled at birth and those sampled at term equivalent age. These results indicate that other, as yet undetermined, factors may influence telomere length in the preterm born infant and raise the intriguing hypothesis that as preterm gestation declines, telomere attrition rate increases.

Highlights

  • Preterm birth, defined by the World Health Organisation as birth at less than 37 weeks completed gestation, is estimated to account for 14.9 million or 11.1% of all births worldwide

  • Birth gestation and birth weight of preterm infants were significantly different (p =

  • Birth gestation and birth weight in preterm infants sampled at birth (Table 1) and preterm infants sampled at term equivalent age (Table 2) were not significantly different (p = 0.28 and 0.18 respectively)

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Summary

Objectives

The aim of this study was to conduct a prospective observational study to compare telomere lengths of preterm infants sampled at birth and at term equivalent age with that of term infants. We aimed to collect a sample within 48 hours of life or at term equivalent age

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