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Very premature birth influences blood pressure and subclinical organ damage in young men born small for gestational age

Although increased rates of cardiovascular (CV) events in subjects born small for gestational age (SGA) were reported, discussion about additional unfavourable effects of premature birth continues. Our aim was to determine CV risk factors and subclinical organ damage in young men born SGA and to analyse the relation and effects of premature birth on CV risk profile and target organ damage. Subjects and Methods: A total of 95 healthy men (21.0 + 0.89 years) born SGA and 90 healthy men (21.5 + 1.02 years) controls with normal intrauterine development were enrolled. Height, weight, body mass index (BMI), waist circumference (WC), office and ambulatory blood pressure (BP), heart rate (HR), fasting blood glucose, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, albumin/creatinine ratio (ACR), eGFR, kidney volume (KV), left ventricular mass index (LVMI), carotid intima media thickness (cIMT) and pulse wave velocity (PWV) were measured in all participants. Birth parameters were obtained from medical records. Results: Higher systolic BP (p = 0.048), 24h BP variability (p = 0.044) (BPV), pulse pressure (PP) (p = 0.008), HR (p = 0.001), altered lipid profile (χ2 = 6.827 p = 0.009), cIMT (p = 0.001), LVMI (p = 0.032), and smaller kidney volume (p < 0.001) and eGFR (p < 0.001) were observed in the whole SGA group. When prematurity was taken into account, higher ambulatory systolic BP (p = 0.001), BPV (p = 0.013), PP (p = 0.002), ACR (p = 0.038), LVMI (p = 0.031) and lower KV (p < 0.001) were found only for very preterm born participants (< 32 weeks). Multiple regression analysis showed pregnancy duration as key determinant of ambulatory systolic BP (ß = -0.54, p = 0.003). Altered lipid profile was more pronounced in the group born SGA at term (χ2 = 7.247 p = 0.027) There were no differences in BMI, WC, FPG, and PWV (p > 0.05) between the SGA participants born prematurely and at term. Conclusion: We found that only very premature birth has an additional unfavourable effect on systolic BP and subclinical target organ damage in young men born SGA. Because of higher risk for developing sustained hypertension and premature cardiovascular incidences, those subjects should be monitored more closely from early adulthood. Our results are in agreement with previous findings showing increased systolic BP, metabolic disturbances, impaired kidney growth and target organ damage to be the characteristics of SGA subjects.

premature birth; blood pressure; organ damage

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