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Cardiometabolic characteristics of school-aged children born preterm with very low birth weight
Rafael Oliveira Fernandes1, Victoria Baptista Dos Santos2, Rafaela Mallmann Saalfeld2
1Graduate Program in Child and Adolescent Health (PPGSCA), Medical School of Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil. rafafernandes.fisio@gmail.com.
Insights
Children born preterm with very low birth weight (VLBW) face higher risks for cardiovascular and metabolic diseases, especially those from lower-income families. Long-term monitoring is crucial for these preterm individuals to improve health outcomes.
Area of Science:
- Pediatrics
- Cardiology
- Endocrinology
Background:
- Preterm birth is a known risk factor for early-onset cardiovascular and metabolic diseases.
- Limited data exists on the cardiometabolic health of preterm individuals from low- and middle-income countries (LMICs).
Purpose of the Study:
- To investigate the cardiometabolic characteristics of school-age children born preterm with very low birth weight (VLBW) compared to term-born children.
- To identify specific risk factors and subgroups within the preterm population requiring closer monitoring.
Main Methods:
- A cross-sectional observational study involving 77 preterm VLBW children and 59 term-born children aged 8-14 years in Southern Brazil.
- Assessment included physical examination, body composition analysis, and fasting blood tests to determine cardiometabolic risk factors such as elevated blood pressure, overweight, dyslipidemia, and dysglycemia.
Main Results:
- Preterm children had a 2.6 times higher odds of elevated blood pressure (BP) compared to term-born children.
- Overweight was less common in preterm children (OR 0.4), who also presented lower fat mass and fat-free mass.
- Dyslipidemia and dysglycemia were highly prevalent in both groups; however, eutrophic preterm children and lower-income preterm children showed higher cardiometabolic risk, including elevated triglycerides in the eutrophic subgroup.
Conclusions:
- School-aged children born preterm with VLBW, particularly those from lower-income families, exhibit an increased risk for cardiovascular and metabolic diseases.
- Findings underscore the need for long-term monitoring of high-risk preterm individuals to mitigate adverse outcomes.
- This study provides crucial insights into the long-term effects of preterm birth in a LMIC context, highlighting disparities and specific vulnerabilities.
Background:
Preterm birth is a risk factor for early-onset cardiovascular and metabolic diseases. However, there is a paucity of data related to cardiometabolic health of preterm individuals from low- and middle-income countries. Our aim was to investigate the cardiometabolic characteristics of school-age children born preterm with very low birth weight (VLBW) compared to term.
Methods:
This cross-sectional observational study recruited 77 children born preterm VLBW in Southern Brazil and 59 term children, aged 8-14 years old. Physical exam, body composition and fasting blood tests were performed. Cardiometabolic risk factors were determined as elevated blood pressure (BP), overweight, dyslipidemia, and dysglycemia.
Results:
Preterm group presented an OR of 2.6 (95% CI 1.05, 6.6) for elevated BP compared to term. Overweight was less common in the preterm (OR 0.4; 95% CI 0.2, 0.9). Dyslipidemia and dysglycemia were not different among groups, with both conditions highly prevalent across them. Preterm group presented lower fat mass (-4.6 kg; 95% CI -7.4, -1.8) and fat-free mass (-2.33 kg; 95% CI -4.27, -0.40) compared to term; lower-income preterm children exhibited higher fat mass. Eutrophic preterm subgroup analysis evidenced elevated triglycerides.
Conclusion:
Children born preterm with VLBW in a LMIC present increased risk for cardiovascular diseases. Eutrophic and lower-income preterm children presented higher cardiometabolic risk, justifying long-term monitoring for adverse outcomes.
Impact:
School-aged children born preterm with very low birth weight, particularly from low-income families, showed increased risk of cardiac and metabolic diseases. This pioneering study of juvenile individuals born preterm in Brazil offers valuable insights into the long-term effects of preterm birth, a field largely explored in the literature from high-income countries. The prevalence of cardiometabolic risk factors-elevated blood pressure, dysglycemia, dyslipidemia, and overweight, in preterm born children is a subject of great concern. Our findings highlight the need for extended follow-up to improve outcomes in high-risk preterm individuals.
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