Cardio-Metabolic Risk in Adults Born Preterm: A Narrative Review

Area of Science:

• Developmental biology
• Cardiovascular medicine
• Metabolic health

Background:

• Neonatal care advances improve survival for extremely preterm infants.
• Preterm birth is now recognized as a determinant of lifelong health.
• This review focuses on the link between preterm birth and later cardiometabolic risk.

Purpose of the Study:

• To synthesize evidence linking preterm birth to cardiometabolic risk.
• To explore the epidemiological and mechanistic basis of this association.
• To highlight the need for improved care for preterm-born individuals.

Main Methods:

• Narrative review of epidemiological data.
• Synthesis of mechanistic studies.
• Analysis of long-term health outcomes in preterm-born adults.

Main Results:

• Adults born preterm exhibit higher rates of heart failure, ischemic heart disease, stroke, atrial fibrillation, and diabetes.
• A distinct phenotype includes increased adiposity, insulin resistance, dyslipidemia, and hypertension.
• Mechanisms involve adipose and cardiac maldevelopment, vascular issues, and nephron deficiency.

Conclusions:

• Preterm birth leads to lasting organ structure and function alterations, reflecting developmental origins of health and disease.
• Adults born preterm are an under-recognized population with accelerated non-communicable disease risk.
• Enhanced physician awareness, care transition, and prevention strategies are crucial.