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Published on: November 20, 2015
Long-Term Consequences of Preterm Birth: A Lifespan Perspective
Lina F Chalak1, Natalie Vega Ortiz2, Jennifer Joukhdar2
1Division of Neonatal-Perinatal Medicine, Department of Pediatrics, UT Southwestern Medical Center and Children's Medical Center, Dallas, Texas, USA, lina.chalak@utsouthwestern.edu.
Insights
Preterm birth can lead to accelerated aging, impacting brain and heart health throughout life. Early adversity in preterm infants affects adult health trajectories, increasing risks for cognitive and cardiovascular issues.
Area of Science:
- Neuroscience
- Cardiology
- Developmental Pediatrics
- Public Health
Background:
- Preterm birth is a significant factor influencing lifelong health, affecting neurodevelopment, psychiatric conditions, cardiovascular health, and mortality.
- Early-life adversity, particularly related to prematurity, is linked to accelerated aging of the brain-heart axis.
- The 'fetus to fifty' model illustrates how early experiences of preterm infants shape their adult health trajectories.
Purpose of the Study:
- To synthesize evidence on the link between early-life adversity and accelerated aging in the brain-heart axis.
- To describe the 'fetus to fifty' model and its implications for preterm-born individuals.
- To identify research gaps and future directions for mitigating premature aging in preterm adults.
Main Methods:
- Literature review synthesizing current evidence.
- Description of the 'fetus to fifty' model.
- Analysis of physiological mechanisms and social determinants.
Main Results:
- Cardiovascular and neurodevelopmental issues in preterm infants are interconnected.
- Suboptimal perinatal hemodynamics and inflammation may lead to a shared cardio-cerebral phenotype.
- Premature cardiovascular aging can compromise cerebrovascular reserve and elevate cognitive decline risk.
Conclusions:
- The early origins of disease are influenced by biological vulnerability and social determinants.
- Understanding the interplay between early experiences and lifelong health is crucial.
- Further research is needed to mitigate premature aging and its associated health risks in preterm-born adults.
Background:
Preterm birth is increasingly recognized as a determinant of health across the lifespan, influencing neurodevelopment, psychiatric risk, cardiovascular function, and mortality. This review synthesizes current evidence linking early life adversity, including that associated with prematurity, to the brain-heart axis. We further describe the "fetus to fifty" model, highlighting how the early life experiences of preterm-born infants impact adult trajectories across the lifespan.
Summary:
Cardiovascular and neurodevelopmental vulnerabilities in preterm-born infants are closely linked. Emerging evidence suggests that suboptimal perinatal hemodynamics and inflammation contribute to a shared cardio-cerebral phenotype, in which premature cardiovascular aging may impair cerebrovascular reserve and increase the risk of cognitive decline.
Key Messages:
We review the fundamental physiology underlying the early origins of diseases relating to mental health, personality, psychiatric diagnosis, neuroanatomical changes, and cardiopulmonary outcomes, emphasizing the interplay between biological vulnerability and social determinants. Lastly, we identify gaps in knowledge and future research directions to better understand preterm-born adults.
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