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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Physical activity, fitness, and cardiac autonomic function among adults born postterm
Päivi Oksanen1,2,3, Marjaana Tikanmäki1,2,3, Mikko P Tulppo3,4
1Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland.
Insights
Infants born postterm (after 42 weeks) had lower physical activity and cardiorespiratory fitness in middle age. This suggests postterm birth is a risk factor for adult cardiometabolic disease.
Area of Science:
- Cardiovascular Health
- Perinatal Medicine
- Public Health
Background:
- Adverse outcomes of postterm birth may persist into adulthood, including cardiometabolic risk factors.
- Previous research suggests links between postterm birth and later health issues like impaired glucose metabolism and obesity.
Purpose of the Study:
- To investigate the long-term effects of postterm birth on cardiovascular health determinants in middle age.
- To examine associations between postterm birth and physical activity, muscular strength, cardiorespiratory fitness, and cardiac autonomic function.
Main Methods:
- Study included 46-year-old adults from the Northern Finland Birth Cohort, comparing those born postterm (n=805) with those born at term (n=2645).
- Assessed physical activity via accelerometry, muscular strength via handgrip strength, cardiorespiratory fitness via a 4-min step test, and cardiac autonomic function (heart rate recovery, variability, baroreflex sensitivity).
- Used multiple linear regression, adjusting for relevant covariates.
Main Results:
- Adults born postterm engaged in 2.0 min/day less vigorous physical activity compared to term-born adults.
- Postterm birth was associated with reduced cardiorespiratory fitness, indicated by higher peak heart rate (2.1 bpm) during a step test.
- Slower heart rate recovery (0.7 bpm at 30s) was observed in postterm-born individuals.
Conclusions:
- Postterm birth is linked to decreased vigorous physical activity and cardiorespiratory fitness in middle age.
- Slower heart rate recovery post-exercise in middle age is associated with a postterm birth history.
- Findings support including postterm birth as a perinatal risk factor for adult cardiometabolic disease.
Abstract:
Recent studies have suggested that adverse outcomes of postterm birth (≥42 completed weeks of gestation), including increased cardiometabolic risk factors, impaired glucose metabolism, and obesity, may extend into adulthood. We studied interconnected determinants of cardiovascular health, including physical activity (PA; based on accelerometry for 2 weeks), muscular strength (measured by handgrip strength), cardiorespiratory fitness (CRF; measured by 4-min step test), and cardiac autonomic function (heart rate [HR] recovery, HR variability, and baroreflex sensitivity) among 46-year-old adults from the Northern Finland Birth Cohort born postterm (n = 805) and at term (n = 2645). Adults born postterm undertook vigorous PA 2.0 min day-1 (95% CI, 0.4-3.7) less than term-born adults when adjusted for sex, age, and maternal- and pregnancy-related covariates in multiple linear regression. Postterm birth was associated with reduced CRF, based on a higher peak HR (2.1 bpm; 95% CI, 0.9-3.4) and slower HR recovery 30 s after the step test (-0.7 bpm; 95% CI, -1.3 to -0.1). Postterm birth was associated with less PA of vigorous intensity and CRF and slower HR recovery in middle age. Our findings reinforce previous suggestions that postterm birth should be included as a perinatal risk factor for adult cardiometabolic disease.
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