Cardiometabolic characteristics of school-aged children born preterm with very low birth weight.

BACKGROUND

Preterm birth is a risk factor for early-onset cardiovascular and metabolic diseases. However, there is a paucity of data related to cardiometabolic health of preterm individuals from low- and middle-income countries. Our aim was to investigate the cardiometabolic characteristics of school-age children born preterm with very low birth weight (VLBW) compared to term.

METHODS

This cross-sectional observational study recruited 77 children born preterm VLBW in Southern Brazil and 59 term children, aged 8-14 years old. Physical exam, body composition and fasting blood tests were performed. Cardiometabolic risk factors were determined as elevated blood pressure (BP), overweight, dyslipidemia, and dysglycemia.

RESULTS

Preterm group presented an OR of 2.6 (95% CI 1.05, 6.6) for elevated BP compared to term. Overweight was less common in the preterm (OR 0.4; 95% CI 0.2, 0.9). Dyslipidemia and dysglycemia were not different among groups, with both conditions highly prevalent across them. Preterm group presented lower fat mass (-4.6 kg; 95% CI -7.4, -1.8) and fat-free mass (-2.33 kg; 95% CI -4.27, -0.40) compared to term; lower-income preterm children exhibited higher fat mass. Eutrophic preterm subgroup analysis evidenced elevated triglycerides.

CONCLUSION

Children born preterm with VLBW in a LMIC present increased risk for cardiovascular diseases. Eutrophic and lower-income preterm children presented higher cardiometabolic risk, justifying long-term monitoring for adverse outcomes.

IMPACT: School-aged children born preterm with very low birth weight, particularly from low-income families, showed increased risk of cardiac and metabolic diseases. This pioneering study of juvenile individuals born preterm in Brazil offers valuable insights into the long-term effects of preterm birth, a field largely explored in the literature from high-income countries. The prevalence of cardiometabolic risk factors-elevated blood pressure, dysglycemia, dyslipidemia, and overweight, in preterm born children is a subject of great concern. Our findings highlight the need for extended follow-up to improve outcomes in high-risk preterm individuals.