Posod Anna, Odri Komazec Irena, Kager Katrin, Pupp Peglow Ulrike, Griesmaier Elke, Schermer Elisabeth, Würtinger Philipp, Baumgartner Daniela, Kiechl-Kohlendorfer Ursula
Department of Pediatrics, Pediatrics II (Neonatology), Medical University of Innsbruck, Innsbruck, Austria.
Department of Pediatrics, Pediatrics III (Pediatric Cardiology, Pulmonology, Allergology and Cystic Fibrosis), Medical University of Innsbruck, Innsbruck, Austria.
PLoS One. 2016 Dec 13;11(12):e0168162. doi: 10.1371/journal.pone.0168162. eCollection 2016.
Cardiovascular disease is the leading cause of death worldwide. Evidence points towards an unfavorable cardiovascular risk profile of former preterm infants in adolescence and adulthood. The aim of this study was to determine whether cardiovascular risk predictors are detectable in former very preterm infants at a preschool age. Five- to seven-year-old children born at <32 weeks' gestational age were included in the study. Same-aged children born at term served as controls. Basic data of study participants were collected by means of follow-up databases and standardized questionnaires. At study visit, anthropometric data, blood pressure readings and aortic intima-media thickness were assessed. Blood samples were obtained after an overnight fast. In comparison to children born at term, former preterm infants had higher systolic and diastolic blood pressure readings (odds ratio [95% confidence interval] per 1-SD higher blood pressure level 3.2 [2.0-5.0], p<0.001 and 1.6 [1.1-1.2], p = 0.008), fasting glucose levels (OR [95% CI] 5.2 [2.7-10.1], p<0.001), homeostasis model assessment index (OR [95% CI] 1.6 [1.0-2.6], p = 0.036), and cholesterol levels (OR [95% CI] 2.1 [1.3-3.4], p = 0.002). Systolic prehypertension (23.7% vs. 2.2%; OR [95% CI] 13.8 [3.1-60.9], p = 0.001), elevated glucose levels (28.6% vs. 5.9%; OR [95% CI] 6.4 [1.4-28.8], p = 0.016), and hypercholesterolemia (77.4% vs. 52.9%; OR [95% CI] 3.0 [1.3-7.1], p = 0.010) were significantly more prevalent in the preterm group. As former very preterm infants display an unfavorable cardiovascular risk profile already at a preschool age, implementation of routine cardiovascular follow-up programs might be warranted.
心血管疾病是全球首要死因。有证据表明, former preterm infants在青少年期和成年期的心血管风险状况不佳。本研究旨在确定在学龄前的former very preterm infants中是否可检测到心血管风险预测指标。研究纳入了孕龄<32周出生的5至7岁儿童。足月出生的同龄儿童作为对照。通过随访数据库和标准化问卷收集研究参与者的基本数据。在研究访视时,评估人体测量数据、血压读数和主动脉内膜中层厚度。过夜禁食后采集血样。与足月出生的儿童相比,former preterm infants的收缩压和舒张压读数更高(血压每升高1个标准差的比值比[95%置信区间]为3.2[2.0 - 5.0],p<0.001;1.6[1.1 - 1.2],p = 0.008)、空腹血糖水平更高(比值比[95%置信区间]为5.2[2.7 - 10.1],p<0.001)、稳态模型评估指数更高(比值比[95%置信区间]为1.6[1.0 - 2.6],p = 0.036)以及胆固醇水平更高(比值比[95%置信区间]为2.1[1.3 - 3.4],p = 0.002)。收缩期高血压前期(23.7%对2.2%;比值比[95%置信区间]为13.8[3.1 - 60.9],p = 0.001)、血糖水平升高(28.6%对5.9%;比值比[95%置信区间]为6.4[1.4 - 28.8],p = 0.016)和高胆固醇血症(77.4%对52.9%;比值比[95%置信区间]为3.0[1.3 - 7.1],p = 0.010)在早产组中显著更为常见。由于former very preterm infants在学龄前就已表现出不良的心血管风险状况,可能有必要实施常规的心血管随访计划。