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Association of gestation and fetal growth restriction on cardiovascular health in preterm-born children

Course, Christopher W., Kotecha, Sarah J., Cousins, Michael, Hart, Kylie, Lowe, John ORCID:, Watkins, W. John ORCID: and Kotecha, Sailesh ORCID: 2023. Association of gestation and fetal growth restriction on cardiovascular health in preterm-born children. Journal of Pediatrics 255 , pp. 42-49. 10.1016/j.jpeds.2022.09.057

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Objectives TO prospectively evaluate the associations of early and current life factors, including gestational age, and fetal growth restriction (FGR) in preterm-born subjects, on cardiovascular health including measures of central and peripheral blood pressure and arterial stiffness and assesscardiovascular changes before and after acute exercise in preterm- and term-born school-aged children. Study Design From 240 children, aged 7-12 years, 204 (141 preterm-born and 63 term-born) had satisfactory data. An oscillometric device recorded cardiovascular measures before and after cycle ergometer exercise testing. Data were analysed with multivariable linear regression and mediation. Results Central systolic blood pressure (SBP) was 6.4mmHg (95%CI 1.2,11.6) higher in preterm-born children with FGR and 3.4mmHg (0.02,6.8) higher in those without FGR when compared with term controls. Augmentation index (AIx) was 4.1% (0.7,7.4) higher in the preterm FGR group when compared with those without FGR but was similar between the latter group and term controls. Regression modelling showed gestational age, female sex, and antenatal smoking, but not FGR, were significantly associated with SBP. In contrast, FGR and fat mass index, but not gestation, were significantly associated with AIx. Cardiovascular exercise responses were similar between all three groups studied. Conclusions Our data show the differential associations of prematurity and FGR on central SBP and AIx. Cardiovascular responses to exercise were similar in all three groups. Preterm-born children with and without FGR are at increased risk of cardiovascular disease in adult life.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Publisher: Elsevier
ISSN: 0022-3476
Funders: MRC
Date of First Compliant Deposit: 27 October 2022
Date of Acceptance: 6 September 2022
Last Modified: 10 Nov 2023 02:08

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