Preterm graduates from the neonatal intensive care unit and future adult cardiac problems: A narrative review

Area of Science:

• Cardiology
• Neonatology
• Public Health

Background:

• Preterm birth (<37 weeks gestation) increases adult cardiovascular disease (CVD) risk.
• Neonatal intensive care unit (NICU) advances improve survival but create long-term health challenges for preterm infants.

Purpose of the Study:

• To review mechanisms linking preterm birth to adult cardiac issues.
• To summarize evidence on hypertension and cardiac remodeling in preterm-born adults.
• To propose strategies for mitigating CVD risk in preterm survivors.

Main Methods:

• Narrative review of recent scientific literature.
• Synthesis of studies on cardiovascular development, epigenetics, and NICU exposures.
• Analysis of controversies in neonatal interventions (e.g., oxygen, nutrition).

Main Results:

• Preterm-born adults exhibit elevated risks of hypertension and cardiac remodeling.
• Neonatal interventions like oxygen therapy and nutrition present ongoing research questions.
• Long-term follow-up strategies, including screening and lifestyle changes, are crucial.

Conclusions:

• Preterm birth poses significant long-term cardiovascular risks.
• Optimal monitoring and prevention strategies for preterm NICU graduates require further definition.
• Addressing the lifelong cardiac health of preterm survivors is essential, especially in resource-limited settings.