Cargando…

Association of Late Preterm Birth and Size for Gestational Age With Cardiometabolic Risk in Childhood

IMPORTANCE: The long-term cardiometabolic consequences of late preterm birth (34-36 weeks’ gestation) are not well understood. OBJECTIVE: To assess whether late preterm birth and size for gestational age are associated with cardiometabolic risk (CMR) in childhood. DESIGN, SETTING, AND PARTICIPANTS:...

Descripción completa

Detalles Bibliográficos
Autores principales: Yoshida-Montezuma, Yulika, Sivapathasundaram, Branavan, Brown, Hilary K., Keown-Stoneman, Charles, de Souza, Russell J., To, Teresa, Borkhoff, Cornelia M., Birken, Catherine S., Maguire, Jonathon L., Anderson, Laura N.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Medical Association 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9142868/
https://www.ncbi.nlm.nih.gov/pubmed/35622362
http://dx.doi.org/10.1001/jamanetworkopen.2022.14379
_version_ 1784715665811177472
author Yoshida-Montezuma, Yulika
Sivapathasundaram, Branavan
Brown, Hilary K.
Keown-Stoneman, Charles
de Souza, Russell J.
To, Teresa
Borkhoff, Cornelia M.
Birken, Catherine S.
Maguire, Jonathon L.
Anderson, Laura N.
author_facet Yoshida-Montezuma, Yulika
Sivapathasundaram, Branavan
Brown, Hilary K.
Keown-Stoneman, Charles
de Souza, Russell J.
To, Teresa
Borkhoff, Cornelia M.
Birken, Catherine S.
Maguire, Jonathon L.
Anderson, Laura N.
author_sort Yoshida-Montezuma, Yulika
collection PubMed
description IMPORTANCE: The long-term cardiometabolic consequences of late preterm birth (34-36 weeks’ gestation) are not well understood. OBJECTIVE: To assess whether late preterm birth and size for gestational age are associated with cardiometabolic risk (CMR) in childhood. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study included 1742 children born in Ontario, Canada, between April 1, 2006, and September 30, 2014, and followed up until September 30, 2019. Data from children enrolled in The Applied Research Group for Kids (TARGet Kids!) primary care practice–based research network were linked to administrative health care data at ICES (formerly known as the Institute for Clinical Evaluative Sciences). Participants were excluded if they had conditions affecting growth (eg, failure to thrive or cystic fibrosis), any acute or chronic conditions (other than asthma and high-functioning autism), severe developmental delay, or families who were unable to communicate in English. EXPOSURES: Late preterm birth, gestational age as a continuous measure, and size for gestational age. MAIN OUTCOMES AND MEASURES: The primary outcome was composite CMR score (overall age- and sex-standardized z score of CMR components, including waist circumference, log triglyceride level, glucose level, systolic blood pressure, and high-density lipoprotein cholesterol level). Secondary outcomes were the individual CMR components. Multivariable linear regression analysis was used to separately evaluate the associations of late preterm birth, continuous gestational age, and size for gestational age with CMR at ages 3 to 12 years. RESULTS: Among 2440 eligible children, 1742 (mean [SD] age, 5.6 [2.2] years; 951 boys [54.6%]) were included in the final cohort. Overall, 87 children (5.0%) were born moderately preterm (<34 weeks’ gestation), 145 (8.3%) were born late preterm (34-36 weeks’ gestation), 455 (26.1%) were born early term (37-38 weeks’ gestation), and 1055 (60.6%) were born full term (≥39 weeks’ gestation). Compared with children born full term, those born moderately preterm (adjusted β = 0.50; 95% CI, 0.24-0.75) and late preterm (adjusted β = 0.27; 95% CI, 0.06-0.47) had higher CMR scores. Each additional gestational week was associated with a 0.06 U (adjusted β; 95% CI, –0.08 to –0.03 U) decrease in CMR. CONCLUSIONS AND RELEVANCE: In this study, children born late preterm and moderately preterm had higher CMR. These results suggest that screening and early-life interventions for these children may prevent cardiometabolic outcomes.
format Online
Article
Text
id pubmed-9142868
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher American Medical Association
record_format MEDLINE/PubMed
spelling pubmed-91428682022-06-10 Association of Late Preterm Birth and Size for Gestational Age With Cardiometabolic Risk in Childhood Yoshida-Montezuma, Yulika Sivapathasundaram, Branavan Brown, Hilary K. Keown-Stoneman, Charles de Souza, Russell J. To, Teresa Borkhoff, Cornelia M. Birken, Catherine S. Maguire, Jonathon L. Anderson, Laura N. JAMA Netw Open Original Investigation IMPORTANCE: The long-term cardiometabolic consequences of late preterm birth (34-36 weeks’ gestation) are not well understood. OBJECTIVE: To assess whether late preterm birth and size for gestational age are associated with cardiometabolic risk (CMR) in childhood. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cohort study included 1742 children born in Ontario, Canada, between April 1, 2006, and September 30, 2014, and followed up until September 30, 2019. Data from children enrolled in The Applied Research Group for Kids (TARGet Kids!) primary care practice–based research network were linked to administrative health care data at ICES (formerly known as the Institute for Clinical Evaluative Sciences). Participants were excluded if they had conditions affecting growth (eg, failure to thrive or cystic fibrosis), any acute or chronic conditions (other than asthma and high-functioning autism), severe developmental delay, or families who were unable to communicate in English. EXPOSURES: Late preterm birth, gestational age as a continuous measure, and size for gestational age. MAIN OUTCOMES AND MEASURES: The primary outcome was composite CMR score (overall age- and sex-standardized z score of CMR components, including waist circumference, log triglyceride level, glucose level, systolic blood pressure, and high-density lipoprotein cholesterol level). Secondary outcomes were the individual CMR components. Multivariable linear regression analysis was used to separately evaluate the associations of late preterm birth, continuous gestational age, and size for gestational age with CMR at ages 3 to 12 years. RESULTS: Among 2440 eligible children, 1742 (mean [SD] age, 5.6 [2.2] years; 951 boys [54.6%]) were included in the final cohort. Overall, 87 children (5.0%) were born moderately preterm (<34 weeks’ gestation), 145 (8.3%) were born late preterm (34-36 weeks’ gestation), 455 (26.1%) were born early term (37-38 weeks’ gestation), and 1055 (60.6%) were born full term (≥39 weeks’ gestation). Compared with children born full term, those born moderately preterm (adjusted β = 0.50; 95% CI, 0.24-0.75) and late preterm (adjusted β = 0.27; 95% CI, 0.06-0.47) had higher CMR scores. Each additional gestational week was associated with a 0.06 U (adjusted β; 95% CI, –0.08 to –0.03 U) decrease in CMR. CONCLUSIONS AND RELEVANCE: In this study, children born late preterm and moderately preterm had higher CMR. These results suggest that screening and early-life interventions for these children may prevent cardiometabolic outcomes. American Medical Association 2022-05-27 /pmc/articles/PMC9142868/ /pubmed/35622362 http://dx.doi.org/10.1001/jamanetworkopen.2022.14379 Text en Copyright 2022 Yoshida-Montezuma Y et al. JAMA Network Open. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the CC-BY License.
spellingShingle Original Investigation
Yoshida-Montezuma, Yulika
Sivapathasundaram, Branavan
Brown, Hilary K.
Keown-Stoneman, Charles
de Souza, Russell J.
To, Teresa
Borkhoff, Cornelia M.
Birken, Catherine S.
Maguire, Jonathon L.
Anderson, Laura N.
Association of Late Preterm Birth and Size for Gestational Age With Cardiometabolic Risk in Childhood
title Association of Late Preterm Birth and Size for Gestational Age With Cardiometabolic Risk in Childhood
title_full Association of Late Preterm Birth and Size for Gestational Age With Cardiometabolic Risk in Childhood
title_fullStr Association of Late Preterm Birth and Size for Gestational Age With Cardiometabolic Risk in Childhood
title_full_unstemmed Association of Late Preterm Birth and Size for Gestational Age With Cardiometabolic Risk in Childhood
title_short Association of Late Preterm Birth and Size for Gestational Age With Cardiometabolic Risk in Childhood
title_sort association of late preterm birth and size for gestational age with cardiometabolic risk in childhood
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9142868/
https://www.ncbi.nlm.nih.gov/pubmed/35622362
http://dx.doi.org/10.1001/jamanetworkopen.2022.14379
work_keys_str_mv AT yoshidamontezumayulika associationoflatepretermbirthandsizeforgestationalagewithcardiometabolicriskinchildhood
AT sivapathasundarambranavan associationoflatepretermbirthandsizeforgestationalagewithcardiometabolicriskinchildhood
AT brownhilaryk associationoflatepretermbirthandsizeforgestationalagewithcardiometabolicriskinchildhood
AT keownstonemancharles associationoflatepretermbirthandsizeforgestationalagewithcardiometabolicriskinchildhood
AT desouzarussellj associationoflatepretermbirthandsizeforgestationalagewithcardiometabolicriskinchildhood
AT toteresa associationoflatepretermbirthandsizeforgestationalagewithcardiometabolicriskinchildhood
AT borkhoffcorneliam associationoflatepretermbirthandsizeforgestationalagewithcardiometabolicriskinchildhood
AT birkencatherines associationoflatepretermbirthandsizeforgestationalagewithcardiometabolicriskinchildhood
AT maguirejonathonl associationoflatepretermbirthandsizeforgestationalagewithcardiometabolicriskinchildhood
AT andersonlauran associationoflatepretermbirthandsizeforgestationalagewithcardiometabolicriskinchildhood