Premature birth affects cardiopulmonary outcomes in adulthood

Early findings from a long-running US study of preterm infants suggest that babies born prematurely face a greater risk of heart and health problems as adults.

The current study, the eighth follow-up funded by the National Institutes of Health’s National Institute of Nursing Research, is determining cardiac and pulmonary outcomes for preterm infants at age 23 years and how cardiopulmonary health is affected by birth weight, neonatal acuity, sex, and current fitness level.

Researchers from the University of Rhode Island analyzed data for a sample of 69 premature infants and 19 term controls from a prospectively followed cohort of 213 preterm infants born between 1985 and 1989 at Women and Infants Hospital in Providence. The subsample was divided into 4 groups defined by birth weight: extremely low birth weight (

Study participants were tested at age 17 for pulmonary function and cardiopulmonary response to exercise and compared to baseline values. Preliminary findings reveal that physical health, growth, and subtle neurologic outcomes were poorer in the preterm groups than for controls. Other data indicate that male sex and birth weight affect early adult pulmonary function, that participants with the lowest birth weight had the poorest pulmonary outcomes and higher resting blood pressure values, and that preterm infants with medical and neurologic acuity showed a 24% to 32% increase in acute and chronic health conditions as adolescents.

Data collection will be completed in the next year.

Previous studies have shown that prolonged stress from invasive and painful procedures experienced in the neonatal intensive care unit by high-risk preterm infants, already compromised with immature pulmonary function, evokes hormonal responses that increase cortisol, which already is linked to hypertension and coronary artery calcification in adults.

The researchers suggest that continued monitoring of adults born prematurely, not only at young adulthood but also as these persons reach middle age, will enhance understanding of the effect of prematurity on adult cardiopulmonary disease.

Sullivan MC, Mitchell PA, Miller RJ, Winchester SB, Ziegler JW. Cardiopulmonary outcomes in young adults born prematurely with varying birth weights. Paper to be presented at: European Group of Pediatric Work Physiology 27th Biennial Conference; September 19-23, 2011; University of Exeter, UK.