Preterm birth: risk factor for early-onset chronic diseases

Luu, Thuy Mai; Katz, Sherri; Leeson, Paul; Thébaud, Bernard; Nuyt, Anne‐Monique

doi:10.1503/cmaj.150450

Cited by 118 publications

(108 citation statements)

References 42 publications

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“…Prematurity is now a well‐recognized risk factor for hypertension and cardiovascular disease 2, 37, 38. The differences we observed in blood pressure values between preterm and term participants are consistent with reported data 2, 39.…”

Section: Discussionsupporting

confidence: 92%

Endothelial Colony‐Forming Cells in Young Adults Born Preterm: A Novel Link Between Neonatal Complications and Adult Risks for Cardiovascular Disease

Bertagnolli

Xie

Paquette

et al. 2018

JAHA

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BackgroundPreterm birth is linked to cardiovascular risks and diseases. Endothelial progenitor cells play a critical role in vascular development and repair. Cord blood endothelial progenitor cells of preterm‐born infants, especially endothelial colony‐forming cells (ECFC), show enhanced susceptibility to prematurity‐related pro‐oxidant stress. Whether ECFC dysfunction is present in adulthood following preterm birth is unknown.Methods and ResultsThis cross‐sectional observational study includes 55 preterm‐born (≤29 gestational weeks) young adults (18–29 years old, 38% male) and 55 sex‐ and age‐matched full‐term controls. ECFC were isolated from peripheral blood; cell proliferative and vascular cord formation capacities were assessed in vitro. Daytime systolic blood pressure was higher, whereas glucose tolerance and body mass index were lower in preterm‐born subjects. ECFC colonies grew in culture for 62% of full‐term‐ and 58% of preterm‐born participants. Preterm‐born participants have formed ECFC colonies later in culture and have reduced proliferation compared with controls. Only in preterm‐born individuals, we observed that the later the ECFC colony grows in culture, the worse was overall ECFC function. In addition, in preterms, elevated systolic blood pressure significantly correlated with reduced ECFC proliferation (rS=−0.463; P=0.030) and numbers of branches formed on matrigel (rS=−0.443; P=0.039). In preterm‐born subjects, bronchopulmonary dysplasia was associated with impaired ECFC function, whereas exposure to antenatal steroids related to better ECFC function.ConclusionsThis study is the first to examine ECFC in preterm‐born adults and to demonstrate ECFC dysfunction compared with full‐term controls. In the preterm‐born group, ECFC dysfunction was associated with bronchopulmonary dysplasia, the major prematurity‐related neonatal morbidity, and with increased systolic blood pressure into adulthood.

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Section: Discussionsupporting

confidence: 92%

Endothelial Colony‐Forming Cells in Young Adults Born Preterm: A Novel Link Between Neonatal Complications and Adult Risks for Cardiovascular Disease

Bertagnolli

Xie

Paquette

et al. 2018

JAHA

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“…The National Institute of Child Health and Human Development described the DOHD concept based on Barker’s hypothesis, a concept of developmental plasticity through which a selection of genes are switched on and off in critical periods to adapt the organism to environmental factors [6]. Target organs identified within this concept are the brain, cardiovascular system, liver, and kidney, and its potential life-long impact is recently gathering attention [7]. …”

Section: Reviewmentioning

confidence: 99%

Renal consequences of preterm birth

et al. 2017

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BackgroundThe developmental origin of health and disease concept identifies the brain, cardiovascular, liver, and kidney systems as targets of fetal adverse programming with adult consequences. As the limits of viability in premature infants have been pushed to lower gestational ages, the long-term impact of prematurity on kidneys still remains a significant burden during hospital stay and beyond.ObjectivesThe purpose of this study is to summarize available evidence, mechanisms, and short- and long-term renal consequences of prematurity and identify nephroprotective strategies and areas of uncertainty.ResultsKidney size and nephron number are known to be reduced in surviving premature infants due to disruption of organogenesis at a crucial developmental time point. Inflammation, hyperoxia, and antiangiogenic factors play a role in epigenetic conditioning with potential life-long consequences. Additional kidney injury from hypoperfusion and nephrotoxicity results in structural and functional changes over time which are often unnoticed. Nephropathy of prematurity and acute kidney injury confound glomerular and tubular maturation of preterm kidneys. Kidney protective strategies may ameliorate growth failure and suboptimal neurodevelopmental outcomes in the short term. In later life, subclinical chronic renal disease may progress, even in asymptomatic survivors.ConclusionAwareness of renal implications of therapeutic interventions and renal conservation efforts may lead to a variety of short and long-term benefits. Adequate monitoring and supplementation of microelement losses, gathering improved data on renal handling, and exploration of new avenues such as reliable markers of injury and new therapeutic strategies in contemporary populations, as well as long-term follow-up of renal function, is warranted.

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“…The etiology of increased BP and CV risk in elderly patients exposed to a developmental insult is less understood. A recent study by Luu et al (27) suggests that physicians consider gestational age and birth weight in the prevention and management of chronic health. Thus, further studies are needed to explore the etiology of accelerated CV aging and increased CV risk that has its origins in early life to properly manage hypertension in the elderly that were born low birth weight or preterm.…”

Section: F317 Birth Weight Blood Pressure Ras and Agementioning

confidence: 99%

Intrauterine growth restriction programs an accelerated age-related increase in cardiovascular risk in male offspring

Dasinger

Intapad

Backstrom

et al. 2016

American Journal of Physiology-Renal Physiology

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Placental insufficiency programs an increase in blood pressure associated with a twofold increase in serum testosterone in male growth-restricted offspring at 4 mo of age. Population studies indicate that the inverse relationship between birth weight and blood pressure is amplified with age. Thus, we tested the hypothesis that intrauterine growth restriction programs an age-related increase in blood pressure in male offspring. Growth-restricted offspring retained a significantly higher blood pressure at 12 but not at 18 mo of age compared with age-matched controls. Blood pressure was significantly increased in control offspring at 18 mo of age relative to control counterparts at 12 mo; however, blood pressure was not increased in growth-restricted at 18 mo relative to growth-restricted counterparts at 12 mo. Serum testosterone levels were not elevated in growth-restricted offspring relative to control at 12 mo of age. Thus, male growth-restricted offspring no longer exhibited a positive association between blood pressure and testosterone at 12 mo of age. Unlike hypertension in male growth-restricted offspring at 4 mo of age, inhibition of the renin-angiotensin system with enalapril (250 mg/l for 2 wk) did not abolish the difference in blood pressure in growth-restricted offspring relative to control counterparts at 12 mo of age. Therefore, these data suggest that intrauterine growth restriction programs an accelerated age-related increase in blood pressure in growth-restricted offspring. Furthermore, this study suggests that the etiology of increased blood pressure in male growth-restricted offspring at 12 mo of age differs from that at 4 mo of age.

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Preterm birth: risk factor for early-onset chronic diseases

Cited by 118 publications

References 42 publications

Endothelial Colony‐Forming Cells in Young Adults Born Preterm: A Novel Link Between Neonatal Complications and Adult Risks for Cardiovascular Disease

Endothelial Colony‐Forming Cells in Young Adults Born Preterm: A Novel Link Between Neonatal Complications and Adult Risks for Cardiovascular Disease

Renal consequences of preterm birth

Intrauterine growth restriction programs an accelerated age-related increase in cardiovascular risk in male offspring

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