Association of Gestation and Fetal Growth Restriction on Cardiovascular Health in Preterm-Born Children - 19/04/23
Abstract |
Objectives |
To prospectively evaluate the associations of early and current life factors, including gestational age and fetal growth restriction in preterm-born subjects, on cardiovascular health including measures of central and peripheral blood pressure and arterial stiffness and assess cardiovascular changes before and after acute exercise in preterm- and term-born school-aged children.
Study design |
From 240 children, aged 7-12 years, 204 (141 preterm-born and 63 term-born) had satisfactory data. An oscillometric device recorded cardiovascular measures before and after cycle ergometer exercise testing. Data were analyzed with multivariable linear regression and mediation.
Results |
Central systolic blood pressure (SBP) was 6.4 mmHg (95% CI, 1.2, 11.6) higher in preterm-born children with fetal growth restriction and 3.4 mmHg (0.02, 6.8) higher in those without fetal growth restriction when compared with term controls. Augmentation index was 4.1% (0.7, 7.4) higher in the preterm fetal growth restriction group when compared with those without fetal growth restriction but was similar between the latter group and term controls. Regression modelling showed gestational age, female sex, and antenatal smoking, but not fetal growth restriction, were significantly associated with SBP. In contrast, fetal growth restriction and fat mass index, but not gestation, were significantly associated with augmentation index. Cardiovascular exercise responses were similar between all 3 groups studied.
Conclusions |
Our data show the differential associations of prematurity and fetal growth restriction on central SBP and augmentation index. Cardiovascular responses to exercise were similar in all 3 groups. Preterm-born children with and without fetal growth restriction are at an increased risk of cardiovascular disease in adult life.
Trial registration |
URL: GB: RHiNO, EudraCT: 2015-003712-20.
Le texte complet de cet article est disponible en PDF.Abbreviations : AGA, FMI, PWV, SBP
Plan
The RHiNO Study was funded by a Medical Research Council Experimental Medicine Challenge Grant (Reference: MR/M022552/1). S.K. reports grants from Medical Research Council and from GSK for conduct of the current study; and grants from National Institute for Health Research/Health Technology Assessment, Aspire Pharma, and Moulton Foundation outside the submitted work. S.J.K. and W.W. report grants from Moulton Foundation outside of this work. The other authors declare no conflicts of interest. |
Vol 255
P. 42 - avril 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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