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Impact of preterm birth on muscle mass and function: a systematic review and meta-analysis
Alyson Deprez1,2, Jéssica H Poletto Bonetto1, Daniela Ravizzoni Dartora1
1Centre Hospitalier Universitaire (CHU) Sainte-Justine Research Center, 3175 Chemin de La Côte-Sainte-Catherine, Montreal, QC, H3T 1C5, Canada.
Insights
Individuals born preterm show reduced skeletal muscle mass and function, impacting exercise capacity throughout life. Further research is needed to understand and address these long-term effects on muscle development.
Area of Science:
- Human Physiology
- Developmental Biology
- Exercise Science
Background:
- Preterm birth impacts critical skeletal muscle development, increasing comorbidity risk.
- Preterm birth is linked to diminished exercise capacity in individuals.
Approach:
- Systematic review and meta-analysis of 25 studies.
- Searched multiple databases (PubMed, MEDLINE, Embase, etc.) for skeletal muscle and preterm birth research.
- Assessed risk of bias and pooled data using R software.
Key Points:
- Individuals born preterm exhibit reduced muscle thickness and lower muscle power (jump test) compared to full-term peers.
- Pooled data showed significant negative effects on muscle mass and function (SMD -0.58 and -0.45).
- Alterations in skeletal muscle mass and function are observed from infancy through adulthood.
Conclusions:
- Emerging evidence suggests preterm birth alters skeletal muscle mass and function development.
- Significant knowledge gaps exist regarding the long-term effects of preterm birth on skeletal muscle.
- Interventions to improve skeletal muscle health in preterm-born individuals are warranted.
Abstract:
Individuals born preterm present lower exercise capacity. Along with the cardiopulmonary responses and activity level, muscle strength is a key determinant of exercise capacity. This systematic review aimed to summarize the current knowledge on the impact of preterm birth on skeletal muscle mass and function across the lifespan. The databases PubMed, MEDLINE, EBM, Embase, CINAHL Plus, Global Index Medicus, and Google Scholar were searched using keywords and MeSH terms related to skeletal muscle, preterm birth, and low birth weight. Two independent reviewers undertook study selection, data extraction, and quality appraisal using Covidence review management. Data were pooled to estimate the prematurity effect on muscle mass and function using the R software. From 4378 studies retrieved, 132 were full-text reviewed and 25 met the inclusion/exclusion criteria. Five studies presented a low risk of bias, and 5 had a higher risk of bias due to a lack of adjustment for confounding factors and presenting incomplete outcomes. Meta-analyses of pooled data from homogenous studies indicated a significant reduction in muscle thickness and jump test (muscle power) in individuals born preterm versus full-term with standardized mean difference and confidence interval of - 0.58 (0.27, 0.89) and - 0.45 (0.21, 0.69), respectively. Conclusion: Overall, this systematic review summarizing the existing literature on the impact of preterm birth on skeletal muscle indicates emerging evidence that individuals born preterm, display alteration in the development of their skeletal muscle mass and function. This work also highlights a clear knowledge gap in understanding the effect of preterm birth on skeletal muscle development. What is Known: • Preterm birth, which occurs at a critical time of skeletal muscle development and maturation, impairs the development of different organs and tissues leading to a higher risk of comorbidities such as cardiovascular diseases. • Preterm birth is associated with reduced exercise capacity. What is New: • Individuals born preterm display alterations in muscle mass and function compared to individuals born at term from infancy to adulthood. • There is a need to develop preventive or curative interventions to improve skeletal muscle health in preterm-born individuals.
