The following is a summary of “Association of Gestation and Fetal Growth Restriction on Cardiovascular Health in Preterm-Born Children,” published in the APRIL 2023 issue of Pediatrics by Course, et al.
For a prospective study, researchers sought to evaluate the associations between early and current life factors, including gestational age and fetal growth restriction in preterm-born subjects and cardiovascular health outcomes. Specifically, the study aimed to assess measures of central and peripheral blood pressure, arterial stiffness, and cardiovascular changes before and after acute exercise in preterm- and term-born school-aged children.
The study included 240 children aged 7-12 years, of whom 204 (141 preterm-born and 63 term-born) had satisfactory data for analysis. Cardiovascular measures were recorded using an oscillometric device before and after cycle ergometer exercise testing. Data were analyzed using multivariable linear regression and mediation analysis.
In preterm-born children, central systolic blood pressure (SBP) was 6.4 mmHg (95% CI, 1.2, 11.6) higher in those with fetal growth restriction and 3.4 mmHg (0.02, 6.8) higher in those without fetal growth restriction compared to term-born controls. The augmentation index, a measure of arterial stiffness, was 4.1% (0.7, 7.4) higher in preterm-born children with fetal growth restriction than those without fetal growth restriction but similar to term-born controls. Regression analysis revealed that gestational age, female sex, and antenatal smoking were significantly associated with SBP, while fetal growth restriction was not.
On the other hand, fetal growth restriction and fat mass index, but not gestation, were significantly associated with the augmentation index. Cardiovascular exercise responses were similar among all three groups studied.
The findings of the study indicated that prematurity and fetal growth restriction have differential associations with central SBP and the augmentation index. However, cardiovascular exercise responses were similar across all three groups. Preterm-born children, both with and without fetal growth restriction, are at an increased risk of cardiovascular disease in adulthood.