A new cardiovascular disease risk factor for young adults: Preterm birth

Area of Science:

• Cardiology
• Neonatology
• Public Health

Background:

• Adults born preterm (before 37 weeks gestation) exhibit a two-fold higher risk of premature cardiovascular mortality.
• Improving survival rates for premature infants result in millions of adults with a history of preterm birth entering the general population.
• Preterm birth is increasingly recognized as a risk factor for lifelong chronic health conditions, not just infant/childhood issues.

Purpose of the Study:

• To highlight the growing evidence of preterm birth as a lifelong cardiovascular risk factor.
• To emphasize the gap between epidemiological findings and clinical practice regarding preterm birth survivors.
• To advocate for incorporating preterm birth history into routine clinical assessments for cardiovascular risk stratification.

Main Methods:

• Review of epidemiological evidence on cardiovascular risk in preterm-born adults.
• Discussion of disrupted cardiogenesis and resulting structural/functional cardiovascular modifications.
• Proposal of a simple screening question for nurse practitioners: "Were you born preterm?"

Main Results:

• Preterm birth is associated with significantly increased cardiovascular mortality risk in adulthood.
• Clinical practice has not yet integrated this evidence, leading to a lack of specific guidelines for preterm survivors.
• Disrupted cardiogenesis is a key mechanism linking preterm birth to later cardiovascular issues.

Conclusions:

• Preterm birth represents a critical, yet often overlooked, risk factor for adult cardiovascular disease.
• Clinicians, particularly nurse practitioners, can improve patient outcomes by inquiring about birth history.
• Integrating preterm birth status into risk assessment can guide health promotion and treatment decisions, mitigating adverse cardiovascular events.