Cardiovascular Health Profile at Age 25 Years in Adults Born Extremely Preterm or Extremely Low Birthweight
Jeanie L.Y. Cheong, Anjali Haikerwal, John D. Wark, Louis Irving, Suzanne M. Garland, George Patton, Michael M.H. Cheung, Lex W. Doyle, for the Victorian Infant Collaborative Study Group
Abstract
Being born extremely preterm (EP; <28 weeks’ gestation) or extremely low birthweight (ELBW; <1000 g birthweight) may predict increased cardiometabolic risk in adulthood, but other early life predictors are less well described. We aimed to (1) compare cardiovascular health profiles between 165 adults born EP/ELBW and 127 controls at age 25 years, drawn from a prospective longitudinal cohort study, recruited at birth in 1991 to 1992; and (2) in the EP/ELBW group, determine early life associations of cardiovascular health. Cardiovascular health profiles were calculated individually for measures of anthropometry, abdominal visceral fat, blood pressure, fasting plasma glucose, insulin, lipids, C-reactive protein, vascular indices, exercise tolerance and smoking status, and summed for an overall score. Cardiovascular health profiles were compared between groups; using logistic regression (individual scores) and the Mann-Whitney U test (cumulative score). Compared with controls, adults born EP/ELBW had less favorable cardiovascular health profiles; individually for abdominal visceral fat (odds ratio, 0.56 [95% CI, 0.33–0.96], P =0.03), blood pressure (odds ratio 0.38 [95% CI, 0.23–0.63], P <0.001), exercise capacity (odds ratio 0.37 [95% CI, 0.22–0.63], P <0.001), and fasting glucose (odds ratio 0.51 [95% CI, 0.31–0.84], P =0.01) and overall (median [interquartile range] 10 [7–11] versus 11 [9–12], P =0.007). Male sex predicted unfavorable abdominal visceral fat, blood pressure and fasting glucose, and favorable exercise capacity. Greater increases in weight Z scores between 2 and 8, and 8 and 18 years predicted less favorable profiles of exercise capacity and visceral fat. Longer-term follow-up is critical to determine the cardiovascular sequelae of adults born EP/ELBW.