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Prematurity and Low Birth Weight and Their Impact on Childhood Growth Patterns and the Risk of Long-Term
Iwona Jańczewska1, Jolanta Wierzba2, Alicja Jańczewska3
1Department of Neonatology, Medical University of Gdansk, Mariana Smoluchowskiego 17 Street, 80-214 Gdansk, Poland.
Insights
Preterm birth impacts lifelong health, increasing risks for cardiovascular and metabolic disorders. Monitoring growth and blood pressure in these children is vital for preventing long-term cardiovascular disease.
Area of Science:
- Neonatology
- Cardiovascular Medicine
- Developmental Pediatrics
Background:
- Preterm birth is a leading cause of neonatal mortality and morbidity globally.
- Improved survival rates for extremely preterm infants increase the risk of long-term health issues.
- Long-term assessment of growth and cardiovascular risk in preterm survivors is crucial.
Purpose of the Study:
- To review the influence of prematurity and low birth weight on childhood growth.
- To examine the associated cardiovascular risk in children, adolescents, and young adults.
- To highlight the need for lifelong health outcome understanding in preterm individuals.
Main Methods:
- Literature review on prematurity, low birth weight, growth, and cardiovascular risk.
- Analysis of studies focusing on cardiovascular and metabolic sequelae in preterm survivors.
- Discussion of surveillance strategies for preterm-born children.
Main Results:
- Adult preterm survivors face increased risks of cardiovascular and metabolic disorders.
- Early childhood may reveal elevated blood pressure, impaired vascular growth, and cardiomyocyte remodeling in preterm infants.
- Rapid postnatal weight gain can negatively impact body composition, obesity, and cardiovascular outcomes.
Conclusions:
- Adverse metabolic alterations in preterm infants increase the risk of hypertension and diabetes in adulthood.
- Preterm-born children and those with fetal growth restriction require surveillance, including blood pressure monitoring.
- Understanding lifelong outcomes is essential for developing preventive strategies and future research for preterm individuals.
Abstract:
Preterm birth (before 37 completed weeks of gestation) is a global health problem, remaining the main reason for neonatal mortality and morbidity. Improvements in perinatal and neonatal care in recent decades have been associated with a higher survival rate of extremely preterm infants, leading to a higher risk of long-term sequelae in this population throughout life. Numerous surveillance programs for formerly premature infants continue to focus on neurodevelopmental disorders, while long-term assessment of the impact of preterm birth and low birth weight on child growth and the associated risk of cardiovascular disease in young adults is equally necessary. This review will discuss the influence of prematurity and low birth weight on childhood growth and cardiovascular risk in children, adolescents and young adults. The risk of cardiovascular and metabolic disorders is increased in adult preterm survivors. In early childhood, preterm infants may show elevated blood pressure, weakened vascular growth, augmented peripheral vascular resistance and cardiomyocyte remodeling. Increased weight gain during the early postnatal period may influence later body composition, promote obesity and impair cardiovascular results. These adverse metabolic alterations contribute to an increased risk of cardiovascular incidents, adult hypertension and diabetes. Preterm-born children and those with fetal growth restriction (FGR) who demonstrate rapid changes in their weight percentile should remain under surveillance with blood pressure monitoring. A better understanding of lifelong health outcomes of preterm-born individuals is crucial for developing strategies to prevent cardiovascular sequelae and may be the basis for future research to provide effective interventions.
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