Preterm Birth and Cardiometabolic Health Trajectories From Birth to Adulthood: The Avon Longitudinal Study of Parents and Children.

BACKGROUND

Adults who were born prematurely (<37 weeks' gestation) are at increased cardiovascular disease risk, but it is unclear when in the life course this risk emerges. Our aim was to compare trajectories of multiple cardiometabolic risk factors from childhood to early adulthood between those who had and had not been born preterm.

METHODS AND RESULTS

Multilevel models were used to compare trajectories from early childhood (<9 years) to age 25 years of body mass index, fat and lean mass, systolic and diastolic blood pressure, lipids, glucose, and insulin, between individuals born preterm (N=311-676; range, 25-36 weeks' gestation) and term (N=4973-10 534) in a UK birth cohort study. We also investigated gestational age as a continuum. In children born preterm (versus term), systolic and diastolic blood pressures were higher at age 7 years (mean predicted differences, 0.7 [95% CI, -0.2 to 1.6] mm Hg and 0.6 [95% CI, -0.04 to 1.3] mm Hg, respectively). By age 18 years, the difference in systolic blood pressure persisted (1.9 [95% CI, 0.8-3.1] mm Hg) and in diastolic blood pressure (0.1 [95% CI, -0.7 to 1.0 mm Hg]) disappeared. By age 25 years, this difference in systolic blood pressure began to attenuate towards the null (0.9 [95% CI, -0.5 to 2.3] mm Hg). Participants born preterm (versus term) had lower body mass index between ages 7 and 18 years, but by age 25 years, there was no difference. Fat and lean mass trajectories were consistent with body mass index. High-density lipoprotein cholesterol was higher and triglycerides lower at birth, in those born preterm, but this difference also disappeared by age 25 years. There was no evidence of differences in glucose and insulin.

CONCLUSIONS

Few, modest differences in cardiometabolic health were found in those born preterm versus term. All disappeared by age 25 years, except the small difference in systolic blood pressure. Longer follow-up is needed to establish if and when cardiometabolic health trajectories diverge between these 2 groups.