Cardiometabolic risk factors in young adults who were born preterm

Abstract

Adults who were born preterm with a very low birth weight have higher blood pressure and impaired glucose regulation later in life compared with those born at term. We investigated cardiometabolic risk factors in young adults who were born at any degree of prematurity in the Preterm Birth and Early Life Programming of Adult Health and Disease (ESTER) Study, a population-based cohort study of individuals born in 1985-1989 in Northern Finland. In 2009-2011, 3 groups underwent clinical examination: 134 participants born at less than 34 gestational weeks (early preterm), 242 born at 34-36 weeks (late preterm), and 344 born at 37 weeks or later (controls). Compared with controls, adults who were born preterm had higher body fat percentages (after adjustment for sex, age, and cohort (1985-1986 or 1987-1989), for those born early preterm, difference = 6.2%, 95% confidence interval (CI): 0.4, 13.2; for those born late preterm, difference = 8.0%, 95% CI: 2.4, 13.8), waist circumferences, blood pressure (for those born early preterm, difference = 3.0 mm Hg, 95% CI: 0.9, 5.1; for those born late preterm, difference = 1.7, 95% CI: -0.1, 3.4), plasma uric acid levels (for those born early preterm, difference = 20.1%, 95% CI: 7.9, 32.3; for those born late preterm, difference = 20.2%, 95% CI: 10.7, 30.5), alanine aminotransferase levels, and aspartate transaminase levels. They were also more likely to have metabolic syndrome (for those born early preterm, odds ratio = 3.7, 95% CI: 1.6, 8.2; for those born late preterm, odds ratio = 2.5, 95% CI: 1.2, 5.3). Elevated levels of conventional and emerging risk factors suggest a higher risk of cardiometabolic disease later in life. These risk factors are also present in the large group of adults born late preterm.

Keywords: blood pressure; glucose metabolism; hypertension; late preterm; obesity; prematurity.

Figure 1.

Flow chart of the study population, Northern Finland, 2009–2011. All subjects who were recruited into the study were born in Northern Finland in 1986–1989. In the Finnish Medical Birth Register data, there were 83 individuals in the random control group who had missing gestational age, 58 of whom did not participate in the Preterm Birth and Early Life Programming of Adult Health and Disease (ESTER) Study and 25 of whom participated. Ten subjects who were born early preterm, 1 subject who was born late preterm, and 4 controls reported severe disability and were excluded from the analysis. Five subjects who were born early preterm, 5 subjects who were born late preterm, and 8 controls reported being pregnant and were excluded from the analysis. Three of the excluded subjects had more than 1 reason for exclusion.

Figure 2.

Prevalence of hypertension, obesity, metabolic syndrome, and fatty liver index greater than 30 in adults who were born early preterm or late preterm compared with adults born at term (controls), Northern Finland, 2009–2011.