Adelaide Medical School and The Robinson Research Institute, The University of Adelaide, Adelaide, Australia.
J Dev Orig Health Dis. 2021 Aug;12(4):539-554. doi: 10.1017/S2040174420000914. Epub 2020 Oct 8.
Emerging evidence demonstrates a link between preterm birth (PTB) and later life cardiovascular disease (CVD). We conducted a systematic review and meta-analysis to compare conventional CVD risk factors between those born preterm and at term. PubMed, CINAHL, SCOPUS, and EMBASE databases were searched. The review protocol is registered in PROSPERO (CRD42018095005). CVD risk factors including systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index, lipid profile, blood glucose, and fasting insulin among those born preterm (<37 weeks' gestation) were compared with those born at term (≥37 weeks' gestation). Subgroup analyses based on gender, age, gestational at birth (<32 weeks' gestation and <28 weeks' gestation), and PTB associated with small for gestational age or average for gestational age were also performed. Fifty-six studies provided data on 308,987 individuals. Being born preterm was associated with 3.26 mmHg (95% confidence interval [CI] 2.08 to 4.44) higher mean SBP and 1.32 mmHg (95% CI: 0.61 to 2.04) higher mean DBP compared to being born at term. Subgroup analyses demonstrated that SBP was higher among (a) preterm compared to term groups from early adolescence until adulthood; (b) females born preterm but not among males born preterm compared to term controls; and (c) those born at <32 weeks or <28 weeks compared to term. Our meta-analyses demonstrate higher SBP and DBP among those born preterm compared to term. The difference in SBP is evident from early adolescence until adulthood.
新出现的证据表明，早产（PTB）与生命后期的心血管疾病（CVD）之间存在关联。我们进行了系统评价和荟萃分析，以比较早产儿和足月出生者之间的常规 CVD 风险因素。检索了 PubMed、CINAHL、SCOPUS 和 EMBASE 数据库。该综述方案已在 PROSPERO（CRD42018095005）中注册。比较了早产儿（<37 周妊娠）和足月出生者（≥37 周妊娠）的 CVD 风险因素，包括收缩压（SBP）、舒张压（DBP）、体重指数、血脂谱、血糖和空腹胰岛素。还根据性别、年龄、出生时的胎龄（<32 周和<28 周）以及与小于胎龄或适于胎龄相关的 PTB 进行了亚组分析。56 项研究提供了 308987 个人的数据。与足月出生者相比，早产儿的平均 SBP 高 3.26mmHg（95%置信区间[CI]：2.08 至 4.44），平均 DBP 高 1.32mmHg（95%CI：0.61 至 2.04）。亚组分析表明，与足月出生者相比，（a）从青春期早期到成年期的早产儿组 SBP 更高；（b）女性早产儿的 SBP 更高，但男性早产儿的 SBP 则没有；（c）<32 周或<28 周出生的早产儿与足月出生者相比 SBP 更高。我们的荟萃分析表明，与足月出生者相比，早产儿的 SBP 和 DBP 更高。从青春期早期到成年期，SBP 的差异是明显的。
