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Pediatr Res. 2017 Feb;81(2):299-306. doi: 10.1038/pr.2016.212. Epub 2016 Oct 27.

Preterm arteries in childhood: dimensions, intima-media thickness, and elasticity of the aorta, coronaries, and carotids in 6-y-old children born extremely preterm.

Author information

1
Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
2
Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden.
3
Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
4
Department of Clinical Sciences, Division of Pediatric Cardiology, Lund University, and Pediatric Heart Center, Skåne University Hospital, Lund, Sweden.
5
Department of Clinical Sciences, Pediatrics, Umeå University, Umeå, Sweden.
6
Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden.
7
Department of Women´s and Children´s Health, Karolinska Institutet, Stockholm, Sweden.
8
Clinical Epidemiology Unit, Karolinska Institutet, Stockholm, Sweden.
9
Department of Clinical Sciences, Division of Pediatrics, Lund University, and Skåne University Hospital, Lund, Sweden.
10
Children´s Hospital, University of Helsinki, Helsinki, Finland.
11
Department of Neonatal Medicine, Karolinska University Hospital, Stockholm, Sweden.

Abstract

BACKGROUND:

Preterm birth increases risk for adult cardiovascular disease. We hypothesized that arteries in 6-y-old children born preterm are narrower, with thicker intima-media and stiffer than in peers born at term.

METHODS:

Children born extremely preterm (EXP, n = 176, birthweights: 348-1,161 g) and at term (CTRL, n = 174, birthweights: 2,430-4,315 g) were included. Using ultrasonography, we determined diameters of the coronaries (CA), common carotid arteries (CCA) and aorta, the carotid intima media thickness (cIMT), and the stiffness index of the CCA and aorta.

RESULTS:

Arteries were 5-10% narrower in EXP than in CTRL (P < 0.005) but after adjustment for body surface area, diameter differences diminished or disappeared. EXP-children born small for gestational age exhibited similar arterial dimensions as those born appropriate for date. The cIMT was 0.38 (SD = 0.04) mm and did not differ between groups. Carotid but not aortic stiffness was lower in EXP than in CTRL.

CONCLUSION:

In 6-y-old children born extremely preterm, conduit arteries are of similar or smaller size than in controls born at term, and they have no signs of accelerated intima media thickening or arterial stiffening. While these findings are reassuring for these children and their families, the causal pathways from preterm birth to adult cardiovascular disease remain unknown.

PMID:
28195589
DOI:
10.1038/pr.2016.212
[Indexed for MEDLINE]

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