Cardiovascular risk factors at age 30 following pre-term birth
Cardiovascular risk factors at age 30 following pre-term birth
复制标题
DOI：
10.1093/ije/dym067
复制
发表时间：
2007-08-01
影响因子：
7.7
通讯作者：
Harding, Jane E.
中科院分区：
文献类型：
--
作者：
Dalziel, Stuart R.;Parag, Varsha;Harding, Jane E.
背景最近的流行病学证据表明，出生时小的人心血管死亡率和相关危险因素增加。然而，缺乏关于早产后成年期心血管危险因素的信息，或区分妊娠期和胎儿生长对出生时小尺寸的相对贡献。方法前瞻性随访458例30岁的母亲参加了一项预防新生儿呼吸窘迫综合征的产前改善的随机对照试验（147例足月出生，311例早产）。结果出生时的胎龄、早产、出生体重Z评分与30岁时血清胆固醇、甘油三酯和皮质醇水平无相关性（P > 0. 05）。1为所有）。然而，早产与30岁时收缩压升高（3.5 mmHg，95%CI 0.9-6.1 mmHg，P = 0.009）和胰岛素抵抗相关[Log（胰岛素曲线下面积）= 0.17，95%CI 0.05-0.28，P=0.006]。出生时胎龄低也与这些结果，而出生体重，调整胎龄，没有。结论成人谁出生中度早产增加血压和胰岛素抵抗在30岁。早产而不是胎儿生长不良是这种关联的主要决定因素。由于早产的发生率和早产儿的存活率都在增加，这一群体可能在总体心血管疾病负担中所占的比例越来越大。
Background Recent epidemiological evidence has shown increased rates of cardiovascular mortality and associated risk factors in those born small. However, scarce information exists concerning cardiovascular risk factors in adulthood following pre-term birth, or distinguishing the relative contributions of length of gestation and fetal growth to small size at birth.Methods Prospective follow-up of 458 30-year-olds whose mothers took part in a randomized controlled trial of antenatal betamethasone for the prevention of neonatal respiratory distress syndrome (147 born at term, 311 born pre-term). Follow-up assessments included anthropometry, blood pressure, blood lipids, early morning cortisol levels and 75 g oral glucose tolerance test.Results Gestational age at birth, pre-term birth, and birth weight z-score were not associated with serum cholesterol, triglyceride or cortisol at age 30 (P > 0. 1 for all). However, pre-term birth was associated with increased systolic blood pressure (3.5 mmHg, 95% CI 0.9-6.1 mmHg, P = 0.009) and insulin resistance at age 30 [Log (Insulin area under the curve) = 0.17, 95% CI 0.05-0.28, P=0.006]. Low gestational age at birth was also associated with these outcomes, whereas birth weight, adjusted for gestational age, was not.Conclusions Adults who were born moderately pre-term have increased blood pressure and insulin resistance at 30 years of age. Pre-term birth rather than poor fetal growth is the major determinant of this association. As both the incidence of pre-term birth and survival amongst those born pre-term are increasing, this group may contribute an increasing proportion to overall cardiovascular disease burden.