Born early, age fast: Consequences of premature birth on chronic disease and accelerated ageing

Area of Science:

• Neonatal care and developmental biology
• Perinatal medicine
• Environmental toxicology

Background:

• Advances in neonatal care improve survival for extremely low gestational age newborns (ELGANs) born at ≤28 weeks gestation.
• The intrauterine environment is critical for organ development, while the extrauterine environment poses significant toxicity risks to ELGANs.
• Factors like supplemental oxygen, infections, and mechanical ventilation contribute to oxidative stress in ELGANs.

Purpose of the Study:

• To review the epidemiology of respiratory, cardiovascular, renal, and metabolic disorders across the lifespan in ELGANs.
• To explore the role of early-life oxidative stress in organ development and disease pathogenesis.
• To investigate the link between oxidative stress, cellular senescence, and epigenetic reprogramming in ELGANs.

Main Methods:

• Literature review of clinical disorders in ELGANs.
• Analysis of the impact of early-life environmental exposures on organ development.
• Exploration of molecular pathways, including oxidative stress, cellular senescence, and epigenetic reprogramming.

Main Results:

• ELGANs are at increased risk for acute conditions like bronchopulmonary dysplasia, pulmonary hypertension, and acute kidney injury.
• Long-term risks for ELGANs include chronic obstructive pulmonary disease, cardiovascular disease, chronic kidney disease, and metabolic diseases.
• These chronic conditions are associated with accelerated aging and higher mortality rates in former ELGANs.

Conclusions:

• Early-life oxidative stress in ELGANs is a critical factor initiating pathways leading to both acute and chronic diseases.
• Understanding these pathways is essential for developing interventions to mitigate long-term health consequences in ELGAN survivors.
• This review highlights the need for comprehensive, lifelong monitoring and care for individuals born extremely prematurely.