Background: Spontaneous preterm birth complicates approximately 5-8% of all pregnancies and is a leading cause of infant morbidity and mortality. Emerging research demonstrates that children born preterm may be at increased risk of cardiovascular disease (CVD) in adult life. We aimed to examine evidence for increased CVD risk factors among children and young adults born preterm.
Methods: We performed a systematic review and meta-analysis on studies reporting cardiovascular risk factors among those born preterm (< 37 weeks gestation) compared to those born at term (≥ 37 weeks gestation). The following electronic databases were searched: PubMed, CINAHL, the Cochrane Library and EMBASE with an end of search date of May 01, 2018. Information was extracted on established CVD risk factors including blood pressure, lipid profile, blood glucose, fasting insulin, body mass index (BMI) and endothelial/microvascular function. The review protocol is registered in PROSPERO (CRD42018095005).
Results: Thirty nine studies provided cumulated data on 892,024 individuals. Those born preterm had 3.45 mmHg (95% CI: 2.31 to 4.58) higher systolic and 1.49 mmHg (95% CI: 0.79 to 2.19) higher diastolic blood pressure and 0.26 mmol/l (95% CI: 0.01 to 0.50) higher total cholesterol compared to those born at term.
Conclusion: Risk factors for CVD are evident during childhood and early adulthood among those born preterm. Early screening of children born preterm may identify those at risk who may benefit from interventions targeted at improving lifestyle factors to reduce the risk for CVD in adult life.