BACKGROUND AND PURPOSE:

• In small clinical studies, preterm birth was associated with altered cardiac structure and increased cardiovascular mortality in the young
• In this study, Carr et al. (Journal of the American College of Cardiology, 2017) examines the association between preterm birth and risk of heart failure in children and young adults

METHODS:

• Prospective register-based cohort study
• 2,665,542 individuals born from 1987 to 2012 were followed up from 1 year of age
• 305 cases were used for this study
• Estimates were adjusted for maternal and pregnancy characteristics, socioeconomic status, and maternal and paternal cardiovascular disease
• Median individual time of follow-up for all subjects was 13.1 years

RESULTS:

• Overall incidence as incidence 0.89 per 100,000 person-years
• Gestational age was inversely associated with the risk of heart failure
• Compared to term (≥37 weeks):
  • <28 weeks GA: Increased risk of heart failure (adjusted relative risk 17; 95% CI 7.96 to 36.3)
  • 28 – 31 weeks GA: Increased risk of heart failure (adjusted relative risk 3.58; 95% CI 1.57 to 8.14)
  • 32 – 36 weeks GA: No risk increase (relative risk: 1.36; 95% CI: 0.87 to 2.13).

CONCLUSION:

• Absolute risk for heart failure is still very low
• There is a strong association between preterm birth before 32 weeks of gestation and heart failure in childhood and young adulthood
• Not clear as to the underlying mechanism for this finding, but alterations of cardiac function in preterm individuals is a known phenomenon
• The authors suggest that this study demonstrates preterm birth is a previously unrecognized risk factor for heart failure and survivors of extremely and very preterm birth should be followed more closely for cardiac function

Learn More – Primary Sources:

Preterm Birth and Risk of Heart Failure Up to Early Adulthood

Related ObG Topics:

Antenatal Corticosteroids – When to Administer?

SMFM Statement: Choice of Progestogen for Preterm Birth Prevention

Does Preterm Birth Increase Risk of Subsequent CVD in Mothers?