Cardiovascular Health Profile at Age 25 Years in Adults Born Extremely Preterm or Extremely Low Birthweight

Abstract

Being born extremely preterm (EP; <28 weeks’ gestation) or extremely low birthweight (ELBW; <1000 g birthweight) may predict increased cardiometabolic risk in adulthood, but other early life predictors are less well described. We aimed to (1) compare cardiovascular health profiles between 165 adults born EP/ELBW and 127 controls at age 25 years, drawn from a prospective longitudinal cohort study, recruited at birth in 1991 to 1992; and (2) in the EP/ELBW group, determine early life associations of cardiovascular health. Cardiovascular health profiles were calculated individually for measures of anthropometry, abdominal visceral fat, blood pressure, fasting plasma glucose, insulin, lipids, C-reactive protein, vascular indices, exercise tolerance and smoking status, and summed for an overall score. Cardiovascular health profiles were compared between groups; using logistic regression (individual scores) and the Mann-Whitney U test (cumulative score). Compared with controls, adults born EP/ELBW had less favorable cardiovascular health profiles; individually for abdominal visceral fat (odds ratio, 0.56 [95% CI, 0.33–0.96], P =0.03), blood pressure (odds ratio 0.38 [95% CI, 0.23–0.63], P <0.001), exercise capacity (odds ratio 0.37 [95% CI, 0.22–0.63], P <0.001), and fasting glucose (odds ratio 0.51 [95% CI, 0.31–0.84], P =0.01) and overall (median [interquartile range] 10 [7–11] versus 11 [9–12], P =0.007). Male sex predicted unfavorable abdominal visceral fat, blood pressure and fasting glucose, and favorable exercise capacity. Greater increases in weight Z scores between 2 and 8, and 8 and 18 years predicted less favorable profiles of exercise capacity and visceral fat. Longer-term follow-up is critical to determine the cardiovascular sequelae of adults born EP/ELBW.