Early origin of adult disease: preterm birth, fetal growth retardation and cardiovascular risk factors in young adults

Objective To study if young adults with low birth weight (LBW) had increased body fat or blood pressure (BP), poorer lung- or endothelial function, or lower maximal oxygen uptake than young adults with normal birth weight (controls). Methods Anthropometric measurements, BP, endothelial function, lung function and maximal oxygen uptake were recorded at age 18 in 37 subjects born prematurely with birth weight Results Both LBW groups were shorter, lighter, had smaller head circumference and higher subscapular-to-triceps skinfold-ratio than controls. Systolic and mean arterial BP was higher in the VLBW compared with the control group, whereas there were no differences between the groups in endothelial function. The VLBW group had reduced dynamic lung volumes and lower maximal oxygen uptake and both LBW groups had lower total lung capacity and lower carbon monoxide transfer factor compared with controls. In particular young adults born VLBW who were also growth retarded in utero had higher indices of central body fat, higher blood pressure and lower maximal oxygen uptake. Conclusions Consistent with the early origin of adult disease hypothesis, we found that very preterm birth, in particular if associated with growth retardation, may increase the risk of high blood pressure and central obesity in adulthood. However, no such risk was found among adolescents born growth retarded at term.