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14-03-2012 | Gynaecology | Article

Preterm birth associated with adverse body composition, favorable lipid profile

Abstract

Free abstract

MedWire News: Young adults who were born preterm have a more favorable lipid profile than those who were born term, although their body composition seems to be disadvantageous, research shows.

The team reports that preterm birth (gestational age <36 weeks) was associated with increased total fat mass, trunk fat, and limb fat mass but a relatively favorable lipid profile in young adulthood.

"Such data are of major importance as an increasing number of children born preterm reach adulthood," write Petra Breukhoven (Erasmus University Medical Centre, Rotterdam, the Netherlands) and team in the Journal of Clinical Endocrinology and Metabolism.

Associations between small size at birth and abnormal cardiovascular parameters later in life have been reported, but it is unknown whether the effect is due to a small size for gestational age or prematurity.

The researchers therefore assessed the long-term effects of gestational age, and particularly preterm birth, on lipid levels and fat mass in early adulthood. They included 455 healthy individuals (167 born preterm and 288 full-term) aged 18-24 years. Lipid levels and body composition, measured by dual-energy X-ray absorptiometry, were compared between the two groups.

After adjustment for possible confounders, young adults born preterm had significantly more total fat mass, trunk fat mass, and limb fat mass than those born term, report Breukhoven et al.

However, preterm individuals had significantly lower lipoprotein (Lp)(a) levels and higher apolipoprotein (apo)A-I levels than those born term. They also had a significantly lower prevalence of adverse apoA-I levels (≤1.20 g/L) compared with those born term (12.6 vs 33.3%).

Abnormal total cholesterol, low-density lipoprotein cholesterol, triglycerides, apoB, Lp(a), and high-density lipoprotein levels occurred less frequently in young adults born preterm than in those born term, but these differences did not reach significance.

The team notes that being born small for gestational age (birth length standard deviation score below -2), in addition to being born preterm, had no effect on fat mass and most lipid levels, except for a small effect on apoB levels.

"Clinical manifestations of CVD [cardiovascular disease] do not usually occur before middle age," write Breukhoven et al. "Assuming that the amount of fat mass of preterm subjects remains higher throughout adulthood, they might develop a more adverse lipid profile on the longer term."

However, the team cautions that the unfavorable changes in body composition could be due to hormonal changes in puberty and adolescence. "Further longitudinal follow-up studies in childhood and adolescence are important to confirm these findings."

By Nikki Withers

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