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Higher blood pressure in adolescent boys after very preterm birth and fetal growth restriction

Liefke, Jonas LU ; Steding-Ehrenborg, Katarina LU ; Sjöberg, Pia LU ; Ryd, Daniel LU ; Morsing, Eva LU ; Arheden, Håkan LU ; Ley, David LU and Hedström, Erik LU orcid (2023) In Pediatric Research 93(7). p.2019-2027
Abstract
Background
Although preterm birth predisposes for cardiovascular disease, recent studies in children indicate normal blood pressure and arterial stiffness. This prospective cohort study therefore assessed blood pressure and arterial stiffness in adolescents born very preterm due to verified fetal growth restriction (FGR).

Methods
Adolescents (14 (13–17) years; 52% girls) born very preterm with FGR (preterm FGR; n = 24) and two control groups born with appropriate birth weight (AGA), one in similar gestation (preterm AGA; n = 27) and one at term (term AGA; n = 28) were included. 24-hour ambulatory blood pressure and aortic pulse wave velocity (PWV) and distensibility by magnetic resonance imaging were... (More)
Background
Although preterm birth predisposes for cardiovascular disease, recent studies in children indicate normal blood pressure and arterial stiffness. This prospective cohort study therefore assessed blood pressure and arterial stiffness in adolescents born very preterm due to verified fetal growth restriction (FGR).

Methods
Adolescents (14 (13–17) years; 52% girls) born very preterm with FGR (preterm FGR; n = 24) and two control groups born with appropriate birth weight (AGA), one in similar gestation (preterm AGA; n = 27) and one at term (term AGA; n = 28) were included. 24-hour ambulatory blood pressure and aortic pulse wave velocity (PWV) and distensibility by magnetic resonance imaging were acquired.

Results
There were no group differences in prevalence of hypertension or in arterial stiffness (all p ≥ 0.1). In boys, diastolic and mean arterial blood pressures increased from term AGA to preterm AGA to preterm FGR with higher daytime and 24-hour mean arterial blood pressures in the preterm FGR as compared to the term AGA group. In girls, no group differences were observed (all p ≥ 0.1).

Conclusions
Very preterm birth due to FGR is associated with higher, yet normal blood pressure in adolescent boys, suggesting an existing but limited impact of very preterm birth on cardiovascular risk in adolescence, enhanced by male sex and FGR.

Impact
Very preterm birth due to fetal growth restriction was associated with higher, yet normal blood pressure in adolescent boys.

In adolescence, very preterm birth due to fetal growth restriction was not associated with increased thoracic aortic stiffness.

In adolescence, very preterm birth in itself showed an existing but limited effect on blood pressure and thoracic aortic stiffness.

Male sex and fetal growth restriction enhanced the effect of preterm birth on blood pressure in adolescence.

Male sex and fetal growth restriction should be considered as additional risk factors to that of preterm birth in cardiovascular risk stratification. (Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Pediatric Research
volume
93
issue
7
pages
2019 - 2027
publisher
International Pediatric Foundation Inc.
external identifiers
  • scopus:85141509927
  • pmid:36344695
ISSN
1530-0447
DOI
10.1038/s41390-022-02367-3
project
Very preterm birth and fetal growth restriction in adolescence - Cardiovascular and renal aspects
language
English
LU publication?
yes
id
5c7626a8-bae4-41f7-b60f-69f6319d1be8
date added to LUP
2022-11-08 09:41:00
date last changed
2023-10-26 14:56:37
@article{5c7626a8-bae4-41f7-b60f-69f6319d1be8,
  abstract     = {{Background<br/>Although preterm birth predisposes for cardiovascular disease, recent studies in children indicate normal blood pressure and arterial stiffness. This prospective cohort study therefore assessed blood pressure and arterial stiffness in adolescents born very preterm due to verified fetal growth restriction (FGR).<br/><br/>Methods<br/>Adolescents (14 (13–17) years; 52% girls) born very preterm with FGR (preterm FGR; n = 24) and two control groups born with appropriate birth weight (AGA), one in similar gestation (preterm AGA; n = 27) and one at term (term AGA; n = 28) were included. 24-hour ambulatory blood pressure and aortic pulse wave velocity (PWV) and distensibility by magnetic resonance imaging were acquired.<br/><br/>Results<br/>There were no group differences in prevalence of hypertension or in arterial stiffness (all p ≥ 0.1). In boys, diastolic and mean arterial blood pressures increased from term AGA to preterm AGA to preterm FGR with higher daytime and 24-hour mean arterial blood pressures in the preterm FGR as compared to the term AGA group. In girls, no group differences were observed (all p ≥ 0.1).<br/><br/>Conclusions<br/>Very preterm birth due to FGR is associated with higher, yet normal blood pressure in adolescent boys, suggesting an existing but limited impact of very preterm birth on cardiovascular risk in adolescence, enhanced by male sex and FGR.<br/><br/>Impact<br/>Very preterm birth due to fetal growth restriction was associated with higher, yet normal blood pressure in adolescent boys.<br/><br/>In adolescence, very preterm birth due to fetal growth restriction was not associated with increased thoracic aortic stiffness.<br/><br/>In adolescence, very preterm birth in itself showed an existing but limited effect on blood pressure and thoracic aortic stiffness.<br/><br/>Male sex and fetal growth restriction enhanced the effect of preterm birth on blood pressure in adolescence.<br/><br/>Male sex and fetal growth restriction should be considered as additional risk factors to that of preterm birth in cardiovascular risk stratification.}},
  author       = {{Liefke, Jonas and Steding-Ehrenborg, Katarina and Sjöberg, Pia and Ryd, Daniel and Morsing, Eva and Arheden, Håkan and Ley, David and Hedström, Erik}},
  issn         = {{1530-0447}},
  language     = {{eng}},
  number       = {{7}},
  pages        = {{2019--2027}},
  publisher    = {{International Pediatric Foundation Inc.}},
  series       = {{Pediatric Research}},
  title        = {{Higher blood pressure in adolescent boys after very preterm birth and fetal growth restriction}},
  url          = {{http://dx.doi.org/10.1038/s41390-022-02367-3}},
  doi          = {{10.1038/s41390-022-02367-3}},
  volume       = {{93}},
  year         = {{2023}},
}