Faculty of Medicine and Health, Boden Collaboration for Obesity, Nutrition, Exercise and Eating Disorders, The University of Sydney, Sydney, NSW2006, Australia.
Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia.
J Dev Orig Health Dis. 2022 Feb;13(1):128-134. doi: 10.1017/S204017442100009X. Epub 2021 Mar 19.
Adults who were born preterm are at increased risk of hypertension and cardiovascular disease in later life. Infants born late preterm are the majority of preterm births; however, the effect of late preterm on risk of cardiovascular disease is unclear. The objective of this study was to assess whether vascular health and cardiac autonomic control differ in a group of late preterm newborn infants compared to a group of term-born infants.A total of 35 healthy late preterm newborn infants, with normal growth (34-36 completed weeks' gestation) and 139 term-born infants (37-42 weeks' gestation) were compared in this study. Aortic wall thickening, assessed as aortic intima-media thickness (IMT) by high-resolution ultrasound, and cardiac autonomic control, assessed by heart rate variability, were measured during the first week of life. Postnatal age of full-term and late preterm infants at the time of the study was 5 days (standard deviation [SD] 5) and 4 days (SD 3), respectively.Infants born late preterm show reduced aortic IMT (574 μm [SD 51] vs. 612 μm [SD 73]) and reduced heart rate variability [log total power 622.3 (606.5) ms2 vs. 1180. 6 (1114.3) ms2], compared to term infants. These associations remained even after adjustment for sex and birth weight.Infants born late preterm show selective differences in markers of cardiovascular risk, with potentially beneficial differences in aortic wall thickness in contrast to potentially detrimental differences in autonomic control, when compared with term-born control infants. These findings provide pathophysiologic evidence to support an increased risk of hypertension and sudden cardiac death in individuals born late preterm.
早产儿在成年后患高血压和心血管疾病的风险增加。晚期早产儿是早产儿的主要人群，但晚期早产儿对心血管疾病风险的影响尚不清楚。本研究旨在评估一组晚期早产儿与一组足月出生婴儿的血管健康和心脏自主神经控制是否存在差异。
本研究共比较了 35 名健康的晚期早产儿（孕龄 34-36 周）和 139 名足月出生婴儿（孕龄 37-42 周）。通过高分辨率超声评估主动脉壁增厚，即主动脉内膜-中层厚度（IMT），并通过心率变异性评估心脏自主神经控制。在生命的第一周测量这些指标。足月和晚期早产儿在研究时的胎龄分别为 5 天（标准差 [SD] 5）和 4 天（SD 3）。
与足月婴儿相比，晚期早产儿的主动脉 IMT 较低（574μm [SD 51] 与 612μm [SD 73]），心率变异性较低[总功率对数 622.3（606.5）ms2 与 1180.6（1114.3）ms2]。即使在校正性别和出生体重后，这些关联仍然存在。
与足月出生的对照婴儿相比，晚期早产儿的心血管风险标志物存在选择性差异，主动脉壁厚度存在潜在有益差异，而自主神经控制存在潜在有害差异。这些发现为高血压和迟发性心脏死亡在晚期早产儿中的发生风险增加提供了病理生理学证据。
