Effects of preterm birth and fetal growth retardation on life-course cardiovascular risk factors among schoolchildren from Colombia: The FUPRECOL study

Abstract

Background: Both fetal growth restriction and prematurity have been associated with cardiometabolic risk in youth and adults, however, data on their combined effects on cardiometabolic health in youth are scarce.

Aims: This study aimed at assessing the effects of birth weight and gestational age combined on life-course cardiovascular risk factors and obesity among schoolchildren from Colombia.

Study design: A cross-sectional study.

Subjects: Participants comprised 2510 Colombian schoolchildren (54.8% girls) aged 9-17.9years.

Outcome measures: Four groups were created according to WHO criteria: those born at term with an appropriate birth weight (≥2500g to ≤4000g) for gestational age (term AGA); those born preterm (<37 to <42 completed weeks) with an appropriate birth weight for gestational age (preterm AGA); those born at term with low birth weight for gestational age (term SGA); and those born preterm with low birth weight for gestational age (preterm SGA). Anthropometric markers (body mass, height, waist circumference, and body mass index), blood pressure, lipids profile, fasting glucose, and pubertal stage were assessed. The prevalence of metabolic syndrome was determined by de Ferranti definition.

Results: There were differences between the 4 groups for calendar age (p=0.011), body mass (p=0.001), height (p=0.001), and body mass index (p=0.027). Overall, preterm SGA group had a greater risk for having elevated fasting glucose and metabolic syndrome (total sample and in boys) compared with term AGA group (p<0.05). For other cardiovascular risk factors, no significant relationships were observed based on birth characteristics.

Conclusions: School-age children and adolescents with combined fetal growth restriction and prematurity exhibited an increased prevalence of glucose risk and metabolic syndrome.

Keywords: Blood pressure; Dyslipidemias; Glucose metabolism; Low birth weight; Metabolic syndrome; Premature birth.