Blood Pressure in Late Adolescence and Very Low Birth Weight

Doyle, Lex W.; Faber, B; Callanan, Catherine; Morley, Ruth

doi:10.1542/peds.111.2.252

Cited by 163 publications

(128 citation statements)

References 17 publications

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“…43 Together, these two studies raise concern that the high blood pressure seen in very low birth weight individuals who reach late adolescence may persist and lead to premature mortality. 44 If true, the therapeutic use of exogenous surfac- Figure 5. Distal microvessels are reduced in aged mice exposed to neonatal oxygen.…”

Section: Discussionmentioning

confidence: 99%

Neonatal Hyperoxia Causes Pulmonary Vascular Disease and Shortens Life Span in Aging Mice

Yee

White

Awad

et al. 2011

The American Journal of Pathology

111

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Bronchopulmonary dysplasia is a chronic lung disease observed in premature infants requiring oxygen supplementation and ventilation. Although the use of exogenous surfactant and protective ventilation strategies has improved survival, the long-term pulmonary consequences of neonatal hyperoxia are unknown. Here, we investigate whether neonatal hyperoxia alters pulmonary function in aging mice. By 67 weeks of age, mice exposed to 100% oxygen between postnatal days 1 to 4 showed significantly a shortened life span (56.6% survival, n ‫؍‬ 53) compared to siblings exposed to room air as neonates (100% survival, n ‫؍‬ 47). Survivors had increased lung compliance and decreased elastance. There was also right ventricular hypertrophy and pathological evidence for pulmonary hypertension, defined by reduction of the distal microvasculature and the presence of numerous dilated arterioles expressing von Willebrand factor and ␣-smooth muscle actin. Consistent with recent literature implicating bone morphogenetic protein (BMP) signaling in pulmonary vascular disease, BMP receptors and downstream phospho-Smad1/ 5/8 were reduced in lungs of aging mice exposed to neonatal oxygen. BMP signaling alterations were not observed in 8-week-old mice. These data suggest that loss of BMP signaling in aged mice exposed to neonatal oxygen is associated with a shortened life span, pulmonary vascular disease, and associated cardiac failure. People exposed to hyperoxia as neonates may be at increased risk for pulmonary hypertension.

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Section: Discussionmentioning

confidence: 99%

Neonatal Hyperoxia Causes Pulmonary Vascular Disease and Shortens Life Span in Aging Mice

Yee

White

Awad

et al. 2011

The American Journal of Pathology

111

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“…7,8 Although most studies have relied on office-measured BP, we are aware of 5 studies that used 24-hour ambulatory BP (ABP) in adults born preterm. Those studies show either elevated BP [9][10][11][12][13] or hypertension, 9 and all are limited to adults born preterm at VLBW or very or extremely (<28 weeks) preterm, comprising the extreme 1% to 1.5% of newborns. Although 24-hour ABP predicts cardiovascular events better than office-measured BP, 14,15 it has not been studied across the entire range of preterm births.…”

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confidence: 99%

Ambulatory Blood Pressure and Its Variability in Adults Born Preterm

et al. 2015

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A pproximately 14.9 million babies (11% of all infants born) worldwide are born preterm (<37 weeks) every year.1 Adults born preterm with very low birth weight (VLBW; <1500 g) or very (<32 weeks) or early (<34 weeks) preterm have higher blood pressure (BP) 2-6 and higher rates of hypertension compared with their peers born at term. There is some evidence of a continuous relationship between shorter length of gestation and higher BP. 7,8 Although most studies have relied on office-measured BP, we are aware of 5 studies that used 24-hour ambulatory BP (ABP) in adults born preterm. Those studies show either elevated BP 9-13 or hypertension, 9 and all are limited to adults born preterm at VLBW or very or extremely (<28 weeks) preterm, comprising the extreme 1% to 1.5% of newborns. Although 24-hour ABP predicts cardiovascular events better than office-measured BP, 14,15 it has not been studied across the entire range of preterm births.In addition to mean BP levels, previous studies have highlighted BP variability as a key factor underlying the progression of organ damage 16 and triggering vascular events. 15 It is also correlated with the development of hypertensive left ventricular hypertrophy. 17 BP variability is studied less often in adults born preterm. We hypothesized that preterm birth, across its entire range, is associated with elevated levels and larger variability of ABP in young adults. MethodsThis study is part of the ESTER (Preterm Birth and Early Life Programming of Adult Health and Disease) study, 18 a case-cohort study with subjects recruited through Northern Finland Birth Cohort Abstract-Adults born preterm have higher blood pressure (BP) than those born at term. Most studies have focused on preterm birth, and few have assessed BP variability, an independent risk factor of cardiovascular disease. We studied the association of preterm birth with 24-hour ambulatory BP, measured by an oscillometric device, in 42 young adults born early preterm (<34 weeks), 72 born late preterm (34-36 weeks), and 103 controls (≥37 weeks). Sleep was confirmed with accelerometry in 72.4% of subjects. The 24-hour systolic BP of adults born early preterm was 5.5 mm Hg higher (95% confidence interval, 1.9-9.3), awake systolic BP was 6.4 mm Hg higher (95% confidence interval, 2.8-10.1), and sleeping systolic BP was 2.9 mm Hg higher (95% confidence interval 0.3-7.5) when adjusted for age, sex, and use of accelerometry. The differences remained similar when adjusted for height, body mass index, physical activity, smoking, parental education, maternal body mass index, smoking during pregnancy, and gestational diabetes mellitus and attenuated slightly when adjusted for maternal hypertensive pregnancy disorders. Adults born early preterm also had higher BP variability as indicated by higher individual standard deviations of systolic BP and diastolic BP. Although our results were consistent with a dose-response relationship between shorter gestation and higher BP, the difference between the late preterm and term groups was not ...

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“…High blood pressure has also been observed in young adolescents who were born preterm (13). It is not known whether some or all of these changes persist into adulthood.…”

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confidence: 99%

Neonatal Hyperoxia Stimulates the Expansion of Alveolar Epithelial Type II Cells

Yee¹,

Buczynski

O’Reilly³

2014

Am J Respir Cell Mol Biol

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Supplemental oxygen used to treat infants born prematurely disrupts angiogenesis and is a risk factor for persistent pulmonary disease later in life. Although it is unclear how neonatal oxygen affects development of the respiratory epithelium, alveolar simplification and depletion of type II cells has been observed in adult mice exposed to hyperoxia between postnatal Days 0 and 4. Because hyperoxia inhibits cell proliferation, we hypothesized that it depleted the adult lung of type II cells by inhibiting their proliferation at birth. Newborn mice were exposed to room air (RA) or hyperoxia, and the oxygenexposed mice were recovered in RA. Hyperoxia stimulated mRNA expressed by type II (Sftpc, Abca3) and type I (T1a, Aquaporin 5) cells and inhibited Pecam expressed by endothelial cells. 5-Bromo-2'-deoxyuridine labeling and fate mapping with enhanced green fluorescence protein controlled statically by the Sftpc promoter or conditionally by the Scgb1a1 promoter revealed increased Sftpc and Abca3 mRNA seen on Day 4 reflected an increase in expansion of type II cells shortly after birth. When mice were returned to RA, this expanded population of type II cells was slowly depleted until few were detected by 8 weeks. These findings reveal that hyperoxia stimulates alveolar epithelial cell expansion when it disrupts angiogenesis. The loss of type II cells during recovery in RA may contribute to persistent pulmonary diseases such as those reported in children born preterm who were exposed to supplemental oxygen.

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Blood Pressure in Late Adolescence and Very Low Birth Weight

Abstract: BP was significantly higher in late adolescence in VLBW survivors than in NBW subjects. Growth restriction in utero was not significantly related to BP in VLBW survivors.

Cited by 163 publications

References 17 publications

Neonatal Hyperoxia Causes Pulmonary Vascular Disease and Shortens Life Span in Aging Mice

Neonatal Hyperoxia Causes Pulmonary Vascular Disease and Shortens Life Span in Aging Mice

Ambulatory Blood Pressure and Its Variability in Adults Born Preterm

Neonatal Hyperoxia Stimulates the Expansion of Alveolar Epithelial Type II Cells

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