Exercise Capacity in Very Low Birth Weight Adults: A Systematic Review and Meta-Analysis

Area of Science:

• Cardiology
• Pediatrics
• Exercise Physiology

Background:

• Very low birth weight (VLBW) is linked to increased adult cardiovascular morbidity and mortality.
• Aerobic fitness, indicated by maximal oxygen consumption (VO2 max), is a key measure of cardiopulmonary health and a cardiovascular mortality predictor.

Purpose of the Study:

• To investigate the impact of birth weight on aerobic exercise capacity and physical activity levels in adults.
• To compare exercise capacity and physical activity in individuals born at VLBW versus term-born controls.

Main Methods:

• Systematic literature search across six databases (MEDLINE, OVID, EMBASE, CINAHL, CENTRAL, Google Scholar).
• Inclusion of studies reporting exercise capacity (VO2 max, VO2 peak) and physical activity in VLBW adults (≥18 years) compared to term-born controls.
• Meta-analysis using a random effects model on eligible studies.

Main Results:

• Meta-analysis of 10 studies (from 15 relevant articles) revealed significantly lower VO2 max in VLBW adults compared to term-born controls (-3.35 mL/kg/min).
• VLBW adults with a history of bronchopulmonary dysplasia showed even greater reductions in VO2 max (-6.08 mL/kg/min).
• Five of nine studies reported reduced self-reported physical activity levels in VLBW individuals.

Conclusions:

• Adults born at VLBW demonstrate diminished maximal aerobic exercise capacity relative to term-born peers.
• Reduced aerobic fitness in VLBW survivors may contribute to their increased risk of cardiovascular disease later in life.