Predicting physical activity in a national cohort of children born extremely preterm

Engan, Mette; Engeseth, Merete Salveson; Fevang, Silje Katrine Elgen; Vollsæter, Maria; Eide, Geir Egil; Røksund, Ola Drange; Halvorsen, Thomas; Clemm, Hege

doi:10.1016/j.earlhumdev.2020.105037

Cited by 13 publications

(26 citation statements)

References 52 publications

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“…Most very preterm born neonates have been exposed to extensive intensive care treatment and long periods of oxygen supplementation that can induce oxidative stress reactions, and might be harmful in a longterm perspective (54). In addition, behavioral issues associated with increased cardiovascular risk, like physical inactivity, may affect cardiovascular health, and previous studies have reported reduced level of activity and physical fitness in preterm born children and adults (55,56). Maternal smoking or exposure to second-hand smoking during pregnancy (57), and maternal diabetes (58) are associated with preterm delivery and also with risk factors of cardiovascular disease in offspring.…”

Section: Discussionmentioning

confidence: 99%

Vascular Endothelial Function Assessed by Flow-Mediated Vasodilatation in Young Adults Born Very Preterm or With Extremely Low Birthweight: A Regional Cohort Study

Engan

Greve

et al. 2021

Front. Pediatr.

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Background: Preterm birth and low birthweight have been associated with increased risk of cardiovascular disease in young adults. Endothelial dysfunction is established as an early marker for development of atherosclerotic cardiovascular disease. Previous studies of endothelial function in young adults born very preterm or with extremely low birthweight have, however, shown diverging results.Objective: We aimed to evaluate the risk of cardiovascular disease as measured by vascular endothelial function in young adults born very preterm (<29 weeks of gestation) or with extremely low birthweight (<1,000 g), compared with term-born controls.Methods: This study included 50 young adults born very preterm or with extremely low birthweight and 49 term-born controls born in Norway in the periods 1982–1985, 1991–1992, and 1999–2000 at mean age 28 (±6) years. The endothelial function was assessed by ultrasound measured flow-mediated dilatation (FMD) of the right brachial artery. The arterial diameter was measured at baseline, after release of 5 min of occlusion, and after sublingual administration of nitroglycerine. FMD was reported as absolute and percentage diameter change from baseline and relative to nitroglycerine-induced dilatation.Results: The participants were mainly normal weight non-smokers, without hypertension, diabetes, or established cardiovascular disease. The cases and controls had mean blood pressure 112/71 (SD 12/9) and 112/69 (SD 11/8) mmHg, body mass index 24.0 (SD 4.2) and 24.4 (SD 4.5) kg/m2, and HbA1c 32.7 (SD 2.5) and 33.0 (SD 2.6) mmol/mol, respectively. For both groups, 4 (8%) were smokers. Mean FMD for the adults born very preterm or with extremely low birthweight was 0.17 mm (95% CI 0.14, 0.21) vs. 0.24 mm (95% CI 0.20, 0.28) for the controls (p = 0.01), corresponding to a percentage increase of 5.4% (95% CI 4.2, 6.6) and 7.6% (95% CI 6.2, 8.9), respectively (p = 0.02). The FMD relative to maximal nitroglycerine-induced dilatation was 20% and 31%, respectively (p = 0.001).Conclusions: Young adults born very preterm or with extremely low birthweight have significantly lower FMD compared with the term-born controls suggesting an increased risk of cardiovascular disease.

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Section: Discussionmentioning

confidence: 99%

Vascular Endothelial Function Assessed by Flow-Mediated Vasodilatation in Young Adults Born Very Preterm or With Extremely Low Birthweight: A Regional Cohort Study

Engan

Greve

et al. 2021

Front. Pediatr.

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“…Within the EP/ELBW group, those without NDD had better PA outcomes. Motor, cognitive and behavioural difficulties at 5 years were considered as possible predictors of PA for children born EP/ELBW, with all three predictors associated with poorer PA outcomes at 11 years 4 …”

Section: Commentarymentioning

confidence: 99%

“…6 As acknowledged by Engan and colleagues, differences in methodology and cohort characteristics make it difficult to make comparisons. 4 The authors identified follow-up rates as a study limitation; the children without PA data from the EP/ELBW group were more likely to have NDD than children with data, which may have decreased the true magnitude of group differences. 4 Further research on PA, using large prospective cohort studies with EP/ELBW and term children, is needed.…”

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confidence: 99%

“…4 The authors identified follow-up rates as a study limitation; the children without PA data from the EP/ELBW group were more likely to have NDD than children with data, which may have decreased the true magnitude of group differences. 4 Further research on PA, using large prospective cohort studies with EP/ELBW and term children, is needed. 1 Where possible, objective PA measures (such as accelerometry) and questionnaires with established psychometric properties should be used, though it is acknowledged that there is no consensus on the best way to measure PA participation.…”

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confidence: 99%

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Predicting poor physical activity outcomes in children born extremely preterm or extremely low birthweight

2020

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With increased survival of children born EP/ELBW, it is important to understand long-term health and development, 1 with many international cohort studies reporting poorer neurodevelopmental outcomes across multiple domains for children born EP/ELBW compared with term. 2,3 Less is known, however, about functional outcomes, including PA participation, for children born EP/ELBW. Using a purpose-built questionnaire at 11 years of age, Engan and colleagues found children born at term had better PA outcomes compared with children born EP/ELBW. Within the EP/ELBW group, those without NDD had better PA outcomes. Motor, cognitive and behavioural difficulties at 5 years were considered as possible predictors of PA for children born EP/ELBW, with all three predictors associated with poorer PA outcomes at 11 years. 4

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“…As the survival of extremely preterm children increases, there is a need to evaluate the outcomes of these children in all aspects of life and health, and how different clinical and behavioural factors might mitigate morbidity. Participation in physical activity can impact the health and well-being of school-aged children 5 , and engagement in physical activity in childhood increases the likelihood of ongoing physical activity in adulthood 6 . Evaluating and encouraging physical activity in preterm born children and youth is therefore important for improving long-term health outcomes.…”

Section: Introductionmentioning

confidence: 99%

Physical activity level in children born extremely preterm: a comparison between children with and without bronchopulmonary dysplasia

Roeper

Blinder

Hayawi

et al. 2022

Preprint

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Introduction: Children with a history of bronchopulmonary dysplasia (BPD) may have lower physical activity levels, but evidence to date is based on self-report. This study compared physical activity levels between children born extremely preterm with and without history of BPD, and examined their associations with pulmonary magnetic resonance imaging (MRI) and pulmonary function test (PFT) indices. Methods: This multi-centre cross-sectional study included children aged 7-9 years born extremely preterm, with and without BPD. Children wore a pedometer for one week, then completed the Physical Activity Questionnaire (PAQ), pulmonary MRI, and PFT. Spearman correlations and multivariable linear regression modelling were performed. Results: Of 45 children, 28 had a history of moderate-severe BPD. There were no differences in any physical activity outcomes by BPD status. Higher average daily step count and higher average daily moderate-vigorous physical activity (MVPA) were each correlated with greater forced vital capacity (r=0.41 and 0.58), greater MRI lung proton density at full expiration (r=0.42 and 0.49), and lower lung clearance index (r=-0.50 and -0.41). After adjusting for MRI total proton density and BPD status, a 5% increase in forced expiratory volume at one second was associated with 738 (95%CI: 208, 1268) more steps per day and 0.1 (0.0, 0.2) more hours of MVPA, respectively. Conclusion: School-aged children born extremely preterm have similar physical activity levels to their peers, regardless of history of BPD. MRI and PFT measures suggestive of gas trapping and/or airflow obstruction are associated with lower physical activity levels.

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Predicting physical activity in a national cohort of children born extremely preterm

Cited by 13 publications

References 52 publications

Vascular Endothelial Function Assessed by Flow-Mediated Vasodilatation in Young Adults Born Very Preterm or With Extremely Low Birthweight: A Regional Cohort Study

Vascular Endothelial Function Assessed by Flow-Mediated Vasodilatation in Young Adults Born Very Preterm or With Extremely Low Birthweight: A Regional Cohort Study

Predicting poor physical activity outcomes in children born extremely preterm or extremely low birthweight

Physical activity level in children born extremely preterm: a comparison between children with and without bronchopulmonary dysplasia

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