Preterm birth and cardiometabolic health trajectories from birth to adulthood: the Avon Longitudinal Study of Parents and Children

Journal article

Background: Adults who were born prematurely (<37 weeks gestation) are at increased cardiovascular disease risk, but it is unclear when in the life course this risk emerges. Our aim was to compare trajectories of multiple cardiometabolic risk factors from childhood to early adulthood between those who had and had not been born preterm.

Methods and Results: Multilevel models were used to compare trajectories from early childhood (<9 years) to age 25 of BMI, fat and lean mass, systolic and diastolic blood pressure (BP), lipids, glucose and insulin, between individuals born preterm (N=311-676, range 25-36 gestation) and term (N=4973-10534) in a UK birth cohort study. We also investigated gestational age as a continuum. In children born preterm (versus term), systolic and diastolic BP were higher at age 7 (mean predicted differences 0.7mmHg;95%CI(-0.2,1.6) and 0.6mmHg;95%CI(-0.04,1.3), respectively). By age 18, the difference in SBP persisted (1.9mmHg;95%CI(0.8,3.1)) and in DBP (0.1mmHg;95%CI(-0.7,1.0)) disappeared. By age 25, this difference in SBP began to attenuate towards the null (0.9mmHg;95%CI(-0.5,2.3)) Participants born preterm (versus term) had lower BMI between ages 7 and 18, but by age 25, there was no difference. Fat and lean mass trajectories were consistent with BMI. HDL-c was higher and triglycerides lower at birth, in those born preterm, but this difference also disappeared by age 25. There was no evidence of differences in glucose and insulin.

Conclusions: Few, modest differences in cardiometabolic health were found in those born preterm versus term. All disappeared by age 25, except the small difference in SBP. Longer follow-up is needed to establish if and when cardiometabolic health trajectories diverge between these two groups.

Authors: Clayton, GL; Howe, LD; O’Keeffe, LM; Lewandowski, A; Lawlor, DA

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: American Heart Association
• Journal: Journal of the American Heart Association Cardiovascular and Cerebrovascular Disease
• Volume: 14
• Issue: 3
• Article number: e030823
• Publication date: 2025-02-03
• Acceptance date: 2024-08-19
• DOI: 10.1161/JAHA.123.030823
• EISSN: 2047-9980
• Language: English
• Keywords: birthweight; preterm; ALSPAC; cardiovascular; cardiometabolic