Presented at the Neonatal Society 2009 Spring Meeting.
Julka D1, Karatza A1,2, Hartnoll G1, Gardiner H2, Modi N1
1 Section of Neonatal Medicine, Division of Medicine, Chelsea & Westrminster Hospital Campus, Imperial College London, 369 Fulham Road, London SW10, UK
2 Division of Surgery, Oncology, Reproductive Biology and Anaesthetics, Imperial College London, Brompton Hospital Campus, London SW10, UK
Background: Preterm birth appears to be a risk factor for higher blood pressure in adult life. Early detection of aberrant cardiovascular development would point to the necessity for focused follow-up.
Aim: To compare indices of cardiovascular function at term in healthy infants born below 32 weeks gestation with a control group of term-born babies studied in the first week after delivery.
Setting: Neonatal unit and postnatal wards at Chelsea & Westminster Hospital, London.
Methods: Intima-media thickness (aIMT) was measured at the dorsal arterial wall of the abdominal aorta using standard ultrasonography. Pulse wave velocity in the brachio-radial segment was measured by a non-invasive method based on the principle of reflectance photoplethysmography. Blood pressure was measured using the Agilent M3046A compact portable patient monitor, taking the average of at least three readings. Statistical analysis was performed using SPSS version 15.0. The study was approved by the local Research Ethics Committee and informed written parental consent was obtained.
Results: Eighteen preterm and twenty one term babies have been studied to date. Systolic blood pressure, pulse pressure and aIMT were significantly greater in the preterm group. The difference in aIMT remained after even after adjusting for aortic diameter and weight.
Conclusion: By term preterm babies have detectable differences in cardiovascular indices in comparison with term born infants. This is in accord with observations of higher blood pressure and greater risk of hypertension in preterm subjects studied in young adult life (1). It would be prudent to include measurement of blood pressure in the follow-up assessments of preterm infants. General physicians need to be alerted to the inclusion of preterm birth as a possible risk factor for cardiovascular disease.
References
1. Johansson et al, Circulation. 2005; 112:3430-6