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Preterm Birth: Long Term Cardiovascular and Renal Consequences.

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Summary

Preterm birth increases the risk of cardiovascular and chronic kidney diseases in adulthood due to altered developmental programming. Antenatal steroids, while beneficial, require cautious use due to potential long-term effects.

Keywords:
DOHaDPreterm infantadultantenatal glucocorticoidscardiovascular diseasechronic kidney diseasehypertensionnephron numbernoncommunicable diseasespreeclampsiaprogrammingsmall for gestational age.

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Area of Science:

  • Developmental biology
  • Neonatal medicine
  • Cardiovascular and renal medicine

Background:

  • Cardiovascular and chronic kidney diseases are leading causes of global premature death.
  • Adverse developmental conditions, like preterm birth, contribute to early origins of these noncommunicable diseases.
  • Improved neonatal care leads to more preterm infants surviving to adulthood, necessitating study of long-term health outcomes.

Purpose of the Study:

  • To review evidence linking preterm birth to cardiovascular and renal diseases in adulthood.
  • To analyze the role of perinatal/neonatal factors, including antenatal steroids.
  • To explore pathogenic mechanisms like developmental programming and epigenetic alterations.

Main Methods:

  • Review of clinical and experimental evidence.
  • Analysis of perinatal and neonatal factors.
  • Investigation of pathogenic mechanisms including developmental programming and epigenetics.

Main Results:

  • Preterm birth is associated with impaired organ development, increasing vulnerability to adult cardiovascular and renal diseases.
  • Antenatal steroid therapy improves preterm birth outcomes but may induce long-term cardiovascular and metabolic alterations.
  • Potential involvement of antenatal steroids in accelerated cellular senescence in preterm individuals.

Conclusions:

  • Preterm-born individuals face a significantly elevated risk of altered cardiovascular and renal function in young adulthood.
  • Specific follow-up strategies for preterm survivors require further determination.
  • Cautious consideration of repeated antenatal steroid therapy is advised due to potential adverse long-term effects.