Preterm arteries in childhood: dimensions, intima-media thickness, and elasticity of the aorta, coronaries, and carotids in 6-y-old children born extremely preterm

Mohlkert, Lilly Ann; Hallberg, Jenny; Broberg, Olof; Hellström, Monica; Halvorsen, Cecilia Pegelow; Sjöberg, Gunnar; Bonamy, Anna Karin Edstedt; Liuba, Petru; Fellman, Vineta; Domellöf, Magnus; Norman, Mikael

doi:10.1038/pr.2016.212

Cited by 25 publications

(36 citation statements)

References 44 publications

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“…The higher LVM in adults could be attributed to higher blood pressures in adults who were born preterm than in those born at term,4 whereas blood pressure differences in our cohort were small or nonexistent. Infants,19 children,7 and adolescents8 born preterm have—as in our cohort—been found to exhibit similar or even lower LVM than peers born at term, also in the presence of elevated blood pressure 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20…”

Section: Discussionsupporting

confidence: 63%

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The Preterm Heart in Childhood: Left Ventricular Structure, Geometry, and Function Assessed by Echocardiography in 6‐Year‐Old Survivors of Periviable Births

Mohlkert

Hallberg

Broberg

et al. 2018

JAHA

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BackgroundPreterm birth has been associated with increased risk of cardiovascular morbidity in adult life. We evaluated whether preterm birth is associated with deviating cardiac structure and function before school start.Methods and ResultsIn total, 176 children aged 6 years and born extremely preterm (EXPT; gestational age of 22–26 weeks) and 134 children born at term (control [CTRL]) were studied. We used echocardiography to assess left heart dimensions, geometry, and functions. Recording and off‐line analyses of echocardiographic images were performed by operators blinded to group belonging. Body size, blood pressure, and heart rate were also measured. Rates of family history of cardiovascular disease and sex distribution were similar in the EXPT and CTRL groups. Heart rate and systolic blood pressure did not differ, whereas diastolic blood pressure was slightly higher in EXPT than CTRL participants. After adjusting for body surface area, left ventricular length, width, and aortic valve annulus diameter were 3% to 5% smaller in EXPT than CTRL participants. Left ventricular longitudinal shortening and systolic tissue velocity were 7% to 11% lower, and transversal shortening fraction was 6% higher in EXPT than CTRL participants. The EXPT group also exhibited lower atrial emptying velocities than the CTRL group. Sex, fetal growth restriction, or a patent ductus arteriosus in the neonatal period did not contribute to cardiac dimensions or performance.ConclusionsSix‐year‐old children born extremely preterm exhibit a unique cardiac phenotype characterized by smaller left ventricles with altered systolic and diastolic functions than same‐aged children born at term.

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Section: Discussionsupporting

confidence: 63%

“…Inclusion and exclusion criteria, perinatal characteristics, and data on survival, neonatal morbidity, neurodevelopmental outcomes at 30 months and 6.5 years of age, and vascular outcomes in childhood have been reported previously 9, 10, 11, 12, 13…”

Section: Methodsmentioning

confidence: 99%

The Preterm Heart in Childhood: Left Ventricular Structure, Geometry, and Function Assessed by Echocardiography in 6‐Year‐Old Survivors of Periviable Births

Mohlkert

Hallberg

Broberg

et al. 2018

JAHA

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“…EXPRESS (Extremely Preterm Infants in Sweden Study) included all pregnant women residing in Sweden and delivering infants before 27 weeks of gestation from April 1, 2004, to March 31, 2007. Detailed characteristics of this prospectively collected population‐based cohort and data on survival, neonatal morbidity, and neurodevelopmental and vascular outcomes were reported previously.…”

Section: Methodsmentioning

confidence: 99%

“…Invitations were sent until 1 control child for each preterm child agreed to participate. If all invited control candidates declined and the list of eligible children was depleted, the controls were listed as missing (n=4; see figure in Mohlkert et al).…”

Section: Methodsmentioning

confidence: 99%

Blood Pressure in 6‐Year‐Old Children Born Extremely Preterm

Bonamy

Mohlkert

Hallberg

et al. 2017

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BackgroundAdvances in perinatal medicine have increased infant survival after very preterm birth. Although this progress is welcome, there is increasing concern that preterm birth is an emerging risk factor for hypertension at young age, with implications for the lifetime risk of cardiovascular disease.Methods and ResultsWe measured casual blood pressures (BPs) in a population‐based cohort of 6‐year‐old survivors of extremely preterm birth (<27 gestational weeks; n=171) and in age‐ and sex‐matched controls born at term (n=172). Measured BP did not differ, but sex, age‐, and height‐adjusted median z scores were 0.14 SD higher (P=0.02) for systolic BP and 0.10 SD higher (P=0.01) for diastolic BP in children born extremely preterm than in controls. Among children born extremely preterm, shorter gestation, higher body mass index, and higher heart rate at follow‐up were all independently associated with higher BP at 6 years of age, whereas preeclampsia, smoking in pregnancy, neonatal morbidity, and perinatal corticosteroid therapy were not. In multivariate regression analyses, systolic BP decreased by 0.10 SD (P=0.08) and diastolic BP by 0.09 SD (P=0.02) for each week‐longer gestation.ConclusionsSix‐year‐old children born extremely preterm have normal but slightly higher BP than their peers born at term. Although this finding is reassuring for children born preterm and their families, follow‐up at older age is warranted.

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“…6,7 Inclusion and exclusion criteria, perinatal characteristics and outcome, and characteristics of the systemic circulation and lung function in childhood have been reported previously. 4,[8][9][10] Children taking part in the EXPRESS study in Lund, Stockholm, and Umeå regions (n = 250; 51% of the national cohort) were invited to a comprehensive followup study of somatic health at the age of 6.5 ± 3 months. In total, 176/250 (70%) children born extremely preterm accepted to be assessed with lung function and echocardiography.…”

Section: Participantsmentioning

confidence: 99%

Lung function and pulmonary vascular resistance are not associated in 6‐year‐old children born extremely preterm

et al. 2019

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Aim Children born preterm are at increased risk of reduced lung function. The aim was to test whether lung function was associated with pulmonary vascular resistance. Methods Participants were recruited from a population‐based cohort born in 2004‐2007. Lung function was assessed with spirometry after administration of a beta2‐agonist. Forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were determined. Estimations of pulmonary vascular resistance, arterial dimensions, right ventricular wall thickness, sphericity, and systolic (TAPSE) and diastolic functions were performed with echocardiography. Adjusted regression analyses were used to study associations. Results Sixty‐six children (33 boys) born at 22‐26 weeks of gestational age (birthweights 460‐1134 g) were assessed at a mean age of 6.7 years. Despite large variations in lung function with FVC z‐scores ranging from −4.6 to +2.8, there were no associations between lung function and pulmonary arterial pressure, right ventricular structure or function. Children with higher FVC z‐scores (r = .52, β = .55 mm, P = .015) and higher FEV1 z‐scores (r = .58, β = .73 mm, P = .001) exhibited larger pulmonary arteries. Conclusion In children born extremely preterm, lung function was not associated with pulmonary vascular resistance. Routine echocardiographic evaluation of extremely preterm children may not be indicated at age 6.5 years.

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Preterm arteries in childhood: dimensions, intima-media thickness, and elasticity of the aorta, coronaries, and carotids in 6-y-old children born extremely preterm

Cited by 25 publications

References 44 publications

The Preterm Heart in Childhood: Left Ventricular Structure, Geometry, and Function Assessed by Echocardiography in 6‐Year‐Old Survivors of Periviable Births

The Preterm Heart in Childhood: Left Ventricular Structure, Geometry, and Function Assessed by Echocardiography in 6‐Year‐Old Survivors of Periviable Births

Blood Pressure in 6‐Year‐Old Children Born Extremely Preterm

Lung function and pulmonary vascular resistance are not associated in 6‐year‐old children born extremely preterm

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