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The long-term effects of prematurity and intrauterine growth restriction on cardiovascular, renal, and metabolic

Patricia Y L Chan1, Jonathan M Morris, Garth I Leslie

  • 1Perinatal Research, Kolling Institute of Medical Research, The University of Sydney, Royal North Shore Hospital, NSW 2065, Australia.

International Journal of Pediatrics
|January 4, 2011
PubMed

Insights

Intrauterine growth restriction (IUGR) poses a greater risk for adolescent hypertension and kidney dysfunction than preterm birth. Children born preterm who are also small for gestational age (SGA) face higher risks of arterial stiffness and metabolic issues.

Area of Science:

  • Pediatrics
  • Cardiovascular Health
  • Metabolic Health

Background:

  • Intrauterine growth restriction (IUGR) and preterm birth are known risk factors for adverse health outcomes.
  • The relative contributions of IUGR and prematurity to adolescent cardiovascular, renal, and metabolic health require further elucidation.

Purpose of the Study:

  • To compare the independent and combined effects of IUGR and preterm birth on adolescent health.
  • To assess risks of cardiovascular, renal, and metabolic dysfunction in periadolescent children based on gestational age and growth status.

Main Methods:

  • Retrospective cohort study of 71 periadolescent children.
  • Participants categorized into four groups: premature SGA, premature AGA, term SGA, and term AGA.
  • Outcome measures included systolic blood pressure (SBP), augmentation index (AI), glomerular filtration rate (GFR), glucose, and insulin levels.

Main Results:

  • Small for gestational age (SGA) children exhibited higher SBP and lower GFR compared to appropriate for gestational age (AGA) children.
  • Prematurity alone did not significantly affect SBP or GFR.
  • Both prematurity and SGA were linked to increased arterial stiffness (AI) and elevated insulin levels post-glucose load.

Conclusions:

  • IUGR is a more significant risk factor than preterm birth for developing systolic hypertension and renal dysfunction in adolescence.
  • Preterm infants who are also SGA are at heightened risk for arterial stiffness and metabolic dysfunction.

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