Does early life programming influence arterial stiffness and central hemodynamics in adulthood?

Area of Science:

• Cardiovascular Physiology
• Developmental Origins of Health and Disease (DOHaD)
• Epidemiology

Background:

• Birth weight is a critical indicator of fetal development and is increasingly recognized as a determinant of long-term health.
• Cardiovascular disease risk factors can originate in early life, influencing adult vascular health.
• Carotid-femoral pulse wave velocity (cfPWV) and augmentation index (AIx) are established markers of arterial stiffness and cardiovascular risk.

Purpose of the Study:

• To investigate the association between birth weight and adult vascular parameters, specifically cfPWV and AIx.
• To determine if associations differ based on gestational age (preterm vs. term) and birth size (small-for-gestational age vs. appropriate-for-gestational age).

Main Methods:

• A cross-sectional study of 1598 participants from the Malmö Birth Data Cohort and Malmö Offspring Study.
• Measurements included birth weight, gestational age, cfPWV, and AIx using Sphygmocor.
• Data were analyzed using multiple linear regression, adjusting for age, sex, gestational age, and cardiovascular risk factors.

Main Results:

• Birth weight was positively associated with cfPWV (β=0.057, P<0.001), particularly in younger adults (18-27 years).
• Birth weight was inversely associated with AIx (β=-0.058, P=0.001), mean arterial pressure (MAP) (β=-0.058, P=0.017), and systolic blood pressure (SBP) (β=-0.047, P=0.031).
• Participants born small-for-gestational age (SGA) exhibited higher AIx and MAP compared to appropriate-for-gestational age (AGA) born individuals. Preterm-born individuals had higher SBP.

Conclusions:

• Lower birth weight is associated with increased arterial stiffness (cfPWV) and altered wave reflection (AIx) in adulthood.
• These findings suggest that adverse birth conditions may program for increased cardiovascular risk later in life.
• Screening for cardiovascular risk factors is recommended for individuals with adverse birth outcomes.