Objective To investigate whether size at birth and growth trajectories in infancy and childhood are associated with determinants of cardiovascular and metabolic risks in young adults born extremely preterm (EP, <26 weeks of gestation).
Methods We used longitudinal data from the EPICure study of 129 EP survivors up to 19 years in the UK and Ireland in 1995. Determinants of cardiovascular and metabolic risks at 19 years included the presence of metabolic syndrome, body mass index (BMI) and systolic blood pressure (SBP). Predictors were birth weight for gestation and gain in weight z-scores in the following periods: birth–postmenstrual age of 40 weeks (term), infancy (term–2.5 years), early childhood (2.5–6.0 years) and late childhood (6–11 years).
Results Metabolic syndrome was present in 8.7% of EP participants at 19 years. Compared with subjects without metabolic syndrome, those with metabolic syndrome tended to have a smaller size at birth (difference in means: −0.55 SD, 95% CI −1.10 to 0.01, p=0.053) and a greater increase in weight z-scores from term to 2.5 years (difference in means: 1.00 SD, 95% CI −0.17 to 2.17, p=0.094). BMI at 19 years was positively related to growth from 2.5 to 6.0 years (β: 1.03, 95% CI 0.31 to 1.75, p=0.006); an inverse association with birthweight z-scores was found in the lower socioeconomic status group (β: −1.79, 95% CI −3.41 to –0.17, p=0.031). Central SBP was positively related to growth from 2.5 to 6.0 years (β: 1.75, 95% CI 0.48 to 3.02, p=0.007).
Conclusion Size at EP birth and increased catch-up in weight from 2.5 to 6.0 years were associated with BMI and central SBP in early adulthood.
- cardiovascular diseases
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Contributors YN contributed to the analysis and interpretation of data, drafted the first version of the manuscript and revised it for important intellectual content. JB assisted in the design of the 19-year follow-up study, collected the data, and reviewed and revised the manuscript for intellectual content. JRH and JKM critically reviewed and revised the manuscript for intellectual content. NM conceptualised and designed the study, obtained funding, supervised data collection, and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.
Funding This study was funded by the Medical Research Council UK (MRC Ref MR/J01107X/1). NM received a proportion of funding from the Department of Health’s NIHR Biomedical Research Centres funding scheme at University College London Hospitals/University College London.
Competing interests NM declares consultancy fees from Novartis and Shire.
Patient consent for publication Not required.
Ethics approval Each follow-up assessment was approved by the ethics committee. Written informed consent was provided by parents up to 11 years and by individual participants at 19 years. The assessment at 19 years was approved by the South Central Hampshire A Research Ethics Committee (Ref: 13/SC/0514).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available subject to the EPICure Data Sharing Policy (www.epicure.ac.uk).