Association of Preterm Birth With Risk of Ischemic Heart Disease in Adulthood

Crump, Casey; Howell, Elizabeth A.; Stroustrup, Annemarie; McLaughlin, Mary Ann; Sundquist, Jan; Sundquist, Kristina

doi:10.1001/jamapediatrics.2019.1327

Cited by 179 publications

(182 citation statements)

References 44 publications

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“…Even small increases in BP are associated with an increase in cardiovascular risk 35. As the increased long-term cardiovascular,5 cerebrovascular36 and renal37 risk associated with preterm birth have been well documented, the impact of haemoglobin on BP in those born preterm is likely to be of clinical relevance.…”

Section: Discussionmentioning

confidence: 99%

“…Worldwide, preterm birth accounts for 10% of births, including 1.5% of very preterm births 2. Very preterm birth is associated with early occurrence of high blood pressure (BP),3 4 and increased risk of ischaemic cardiovascular disease,5 but pathophysiological mechanisms leading to this increase in BP remain to be determined. Very preterm birth is also associated with a higher risk of airflow obstruction, which is further increased in subjects with a history of bronchopulmonary dysplasia (BPD) 6…”

Section: Introductionmentioning

confidence: 99%

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Duration of neonatal oxygen supplementation, erythropoiesis and blood pressure in young adults born preterm

Flahault

Girard‐Bock

Fernandes

et al. 2020

Thorax

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BackgroundAlthough erythropoiesis is impaired and anaemia frequent in neonates born preterm, haematopoiesis in adults born preterm has not been previously studied.ObjectiveWe, thus, aimed to evaluate haemoglobin and erythropoietin levels in young adults born preterm, to identify neonatal events associated with erythropoiesis in adulthood and to examine the relationships of haemoglobin levels with respiratory function and blood pressure.MethodsWe assessed a cohort of 101 young adults (ages 18–29) born preterm (≤29 weeks of gestation), in comparison to 105 full-term controls. We measured haemoglobin, erythropoietin levels and blood pressure. We also assessed respiratory function using spirometry.ResultsCompared with controls, tobacco use and sex-adjusted haemoglobin levels were 5.3 (95% CI 2.9 to 7.7) g/L higher in preterm-born individuals, but erythropoietin levels were similar. Duration of oxygen supplementation in the neonatal period was independently associated with higher haemoglobin levels in the preterm group. In young adults born preterm with bronchopulmonary dysplasia, airflow limitation was associated with higher haemoglobin levels. Both systolic (SBP) and diastolic (DBP) blood pressure were increased in individuals born preterm (p=0.042 and p=0.0008, respectively). Higher haemoglobin levels were associated with higher SBP and DBP, independently of term or preterm status. Mediation analysis suggests that haemoglobin increase contributes to 37% and 32% of the effect of preterm birth on SBP and DBP, respectively.ConclusionsHaemoglobin levels are higher in young adults born preterm, while erythropoietin levels are similar, especially in case of bronchopulmonary dysplasia and airflow limitation, and haemoglobin increase is associated with elevated blood pressure in this population.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Duration of neonatal oxygen supplementation, erythropoiesis and blood pressure in young adults born preterm

Flahault

Girard‐Bock

Fernandes

et al. 2020

Thorax

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“…Other study variables Other perinatal and maternal characteristics that may be associated with gestational age at birth and diabetes were identified using the Swedish Birth Registry and national census data, which were linked using an anonymous personal identification number [25][26][27]. The following were included as adjustment variables: birth year (continuous and categorical by decade), sex, birth order (1, 2, ≥3), maternal age at delivery (continuous), maternal education level (≤9, 10-12, >12 years), maternal birth country or region (Sweden, other Europe/US/Canada, Asia/Oceania, Africa, Latin America, other/unknown), maternal BMI (continuous), maternal smoking (0, 1-9, ≥10 cigarettes/day), diabetes during pregnancy (i.e.…”

Section: Methodsmentioning

confidence: 99%

Preterm birth and risk of type 1 and type 2 diabetes: a national cohort study

Crump

Sundquist

2019

Diabetologia

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Aims/hypothesis Preterm birth (gestational age <37 weeks) has been associated with insulin resistance early in life. However, no large population-based studies have examined risks of type 1 and type 2 diabetes and potential sex-specific differences from childhood into adulthood. Clinicians will increasingly encounter adults who were born prematurely and will need to understand their long-term risks. We hypothesised that preterm birth is associated with increased risks of type 1 and type 2 diabetes into adulthood. Methods A national cohort study was conducted of all 4,193,069 singletons born in Sweden during 1973-2014, who were followed up for type 1 and type 2 diabetes identified from nationwide diagnoses and pharmacy data to the end of 2015 (maximum age 43 years; median age at the end of follow-up 22.5 years). Cox regression was used to adjust for potential confounders, and cosibling analyses assessed the influence of shared familial (genetic and/or environmental) factors. Results In 92.3 million person-years of follow-up, 27,512 (0.7%) and 5525 (0.1%) people were identified with type 1 and type 2 diabetes, respectively. Gestational age at birth was inversely associated with both type 1 and type 2 diabetes risk. Adjusted HRs for type 1 and type 2 diabetes at age <18 years associated with preterm birth were 1.21 (95% CI, 1.14, 1.28) and 1.26 (95% CI, 1.01, 1.58), respectively, and at age 18-43 years were 1.24 (95% CI, 1.13, 1.37) and 1.49 (95% CI, 1.31, 1.68), respectively, compared with full-term birth. The associations between preterm birth and type 2 (but not type 1) diabetes were stronger among females (e.g. at age 18-43 years, females: adjusted HR, 1.75; 95% CI, 1.47, 2.09; males: 1.28; 95% CI, 1.08, 1.53; p < 0.01 for additive and multiplicative interaction). These associations were only partially explained by shared genetic or environmental factors in families. Conclusions/interpretation In this large national cohort, preterm birth was associated with increased risk of type 1 and type 2 diabetes from childhood into early to mid-adulthood. Preterm-born children and adults may need early preventive evaluation and long-term monitoring for diabetes.

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“…The incidence rate of preterm birth is anticipated to increase steeply over the next decade [2]. Multiple health indexes are associated with preterm birth, including childhood obesity [3], kidney diseases, and heart disease in adulthood [4][5][6]. The identification of modifiable factors to reduce preterm birth is urgently needed.…”

Section: Introductionmentioning

confidence: 99%

Prepregnancy Overweight and Obesity Are Associated with an Increased Risk of Preterm Birth in Chinese Women

Huang

et al. 2020

Obes Facts

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Introduction: The association between obesity before pregnancy and preterm birth varies with age and ethnicity. Objective: To study the association between early body mass index (BMI) and risk of preterm birth in Chinese women. Methods: This was a hospital-based retrospective cohort study including 36,596 Chinese women who gave birth to a live singleton infant from 2015 to 2018. Women were classified as underweight (BMI < 18.5), normal weight (BMI 18.5 to < 23), overweight (BMI 23 to < 27.5), or obese (BMI ≥27.5) according to the most recent criteria for Asian women. Multivariate log-binomial regression models were used to estimate the relative risks (RRs) and 95% confidence intervals (95% CIs) for preterm birth among different groups. Results: Compared to women with normal weight, women with overweight or obesity before pregnancy had an increased risk of preterm birth; the RRs and 95% CIs were 1.22 (95% CI: 1.08-1.37) and 1.30 (95% CI: 1.01-1.69), respectively. The greatest risk of extremely preterm birth was observed in obese women. The estimators were robust when considering the maternal age and rate of gestational weight gain (GWG) during pregnancy. Conclusions: Women with overweight and obesity had an increased risk of preterm birth regardless of GWG in early pregnancy. Our study suggests that it is beneficial to lose weight before conception for both overweight and obese women who plan to become pregnant.

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Association of Preterm Birth With Risk of Ischemic Heart Disease in Adulthood

Cited by 179 publications

References 44 publications

Duration of neonatal oxygen supplementation, erythropoiesis and blood pressure in young adults born preterm

Duration of neonatal oxygen supplementation, erythropoiesis and blood pressure in young adults born preterm

Preterm birth and risk of type 1 and type 2 diabetes: a national cohort study

Prepregnancy Overweight and Obesity Are Associated with an Increased Risk of Preterm Birth in Chinese Women

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