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The association between late preterm birth and cardiometabolic conditions across the life course: A systematic review

Yulika Yoshida-Montezuma1, Erica Stone1, Saman Iftikhar1

  • 1Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Paediatric and Perinatal Epidemiology
|November 22, 2021
PubMed

Insights

Late preterm birth increases the risk of diabetes and hypertension, but evidence certainty is low. More research is needed to understand these long-term cardiometabolic health effects.

Area of Science:

  • Perinatal Medicine
  • Public Health
  • Epidemiology

Background:

  • The long-term cardiometabolic health implications of late preterm birth (34-36 weeks gestation) remain incompletely understood.
  • This systematic review addresses the association between late preterm birth and adverse cardiometabolic outcomes throughout the lifespan.

Purpose of the Study:

  • To systematically review and synthesize evidence on the association between late preterm birth and cardiometabolic outcomes in children and adults.
  • To compare outcomes for late preterm infants versus those born at term.

Main Methods:

  • A systematic literature search was conducted in EMBASE, MEDLINE, and CINAHL up to July 2021.
  • Meta-analyses were performed on data from 41 observational studies (over 41 million participants) for outcomes including diabetes, hypertension, ischemic heart disease (IHD), and body mass index (BMI).
  • Risk of bias and certainty of evidence were assessed using the Newcastle-Ottawa scale and GRADE approach, respectively.

Main Results:

  • Late preterm birth was associated with an increased risk of diabetes (RR 1.24) and hypertension (RR 1.21) in combined pediatric and adult populations, with low certainty evidence.
  • A decrease in BMI z-scores was observed in children born late preterm (SMD -0.38), though with very low certainty.
  • Evidence for an increased risk of ischemic heart disease in adults born late preterm was insufficient (HR 1.20).

Conclusions:

  • Late preterm birth is linked to higher risks of developing diabetes and hypertension.
  • The certainty of the evidence supporting these associations is low to very low.
  • Limitations including inconsistent definitions and confounding factors hinder definitive conclusions and highlight the need for further investigation.
Abstract

Keywords:
cardiovasculardiabeteslate pretermmeta-analysissystematic review

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