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Aortic growth arrest after preterm birth: a lasting structural change of the vascular tree

Published online by Cambridge University Press:  01 August 2011

U. Schubert ,
M. Müller ,
A.-K. Edstedt Bonamy ,
H. Abdul-Khaliq  and
M. Norman
U. Schubert*
Affiliation:
Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska University Hospital, Stockholm, Sweden
M. Müller
Affiliation:
Department of Pediatric Cardiology, Saarland University Hospital, Homburg (Saar), Germany
A.-K. Edstedt Bonamy
Affiliation:
Department of Women's and Children's Health, Karolinska University Hospital, Stockholm, Sweden
H. Abdul-Khaliq
Affiliation:
Department of Pediatric Cardiology, Saarland University Hospital, Homburg (Saar), Germany
M. Norman
Affiliation:
Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska University Hospital, Stockholm, Sweden
*
*Address for correspondence: U. Schubert, Neonatal Research Unit B79, Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Huddinge, S-141 86 Stockholm, Sweden. (Email [email protected])
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Abstract

Young people who are born very preterm exhibit a narrower arterial tree as compared with people born at term. We hypothesized that such arterial narrowing occurs as a direct result of premature birth. The aim of this study was to compare aortic and carotid artery growth in infants born preterm and at term. Observational and longitudinal cohort study of 50 infants (21 born very preterm, all appropriate for gestational age, 29 controls born at term) was conducted. Diameters of the upper abdominal aorta and common carotid artery were measured with ultrasonography at three months before term, at term and three months after term-equivalent age. At the first assessment, the aortic end-diastolic diameter (aEDD) was slightly larger in very preterm infants as compared with fetal dimensions. Fetal aortic EDD increased by 2.6 mm during the third trimester, whereas very preterm infants exhibited 0.9 mm increase in aEDD during the same developmental period (P < 0.001 for group difference). During the following 3-month period, aortic growth continued unchanged (+0.9 mm) in very preterm infants, whereas postnatal growth in term controls slowed down to +1.3 mm (P < 0.001 v. fetal aortic growth). At the final examination, aEDD was 22% and carotid artery EDD was 14% narrower in infants born preterm compared with controls, also after adjusting for current weight (P < 0.01). Aortic and carotid artery growth is impaired after very preterm birth, resulting in arterial narrowing. Arterial growth failure may be a generalized vascular phenomenon after preterm birth, with implications for cardiovascular morbidity in later life.

Keywords

aortacarotid arterypreterm birthrisk factorsultrasound
Type
Original Articles
Information
Journal of Developmental Origins of Health and Disease , Volume 2 , Issue 4 , August 2011 , pp. 218 - 225
Copyright
Copyright © Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2011

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References

1.Fellman, V, Hellstrom-Westas, L, Norman, M, et al. One-year survival of extremely preterm infants after active perinatal care in sweden. JAMA. 2009; 301, 2225–2233.Google ScholarPubMed
2.Rotteveel, J, van Weissenbruch, MM, Twisk, JW, Delemarre-Van de Waal, HA. Infant and childhood growth patterns, insulin sensitivity, and blood pressure in prematurely born young adults. Pediatrics. 2008; 122, 313–321.CrossRefGoogle ScholarPubMed
3.Bonamy, AK, Bendito, A, Martin, H, et al. Preterm birth contributes to increased vascular resistance and higher blood pressure in adolescent girls. Pediatr Res. 2005; 58, 845–849.CrossRefGoogle ScholarPubMed
4.Johansson, S, Iliadou, A, Bergvall, N, et al. Risk of high blood pressure among young men increases with the degree of immaturity at birth. Circulation. 2005; 112, 3430–3436.CrossRefGoogle ScholarPubMed
5.Doyle, LW, Faber, B, Callanan, C, Morley, R. Blood pressure in late adolescence and very low birth weight. Pediatrics. 2003; 111, 252–257.CrossRefGoogle ScholarPubMed
6.Irving, RJ, Belton, NR, Elton, RA, Walker, BR. Adult cardiovascular risk factors in premature babies. Lancet. 2000; 355, 2135–2136.CrossRefGoogle ScholarPubMed
7.Hofman, PL, Regan, F, Jackson, WE, et al. Premature birth and later insulin resistance. N Engl J Med. 2004; 351, 2179–2186.CrossRefGoogle ScholarPubMed
8.Kaijser, M, Bonamy, AK, Akre, O, et al. Perinatal risk factors for diabetes in later life. Diabetes. 2009; 58, 523–526.CrossRefGoogle ScholarPubMed
9.Hovi, P, Andersson, S, Eriksson, JG, et al. Glucose regulation in young adults with very low birth weight. N Engl J Med. 2007; 356, 2053–2063.CrossRefGoogle ScholarPubMed
10.Koupil, I, Leon, DA, Lithell, HO. Length of gestation is associated with mortality from cerebrovascular disease. J Epidemiol Community Health. 2005; 59, 473–474.CrossRefGoogle ScholarPubMed
11.Bensley, JG, Stacy, VK, De Matteo, R, Harding, R, Black, MJ. Cardiac remodelling as a result of pre-term birth: Implications for future cardiovascular disease. Eur Heart J. 2010; 31, 2058–2066.CrossRefGoogle ScholarPubMed
12.Cohen, G, Vella, S, Jeffery, H, Lagercrantz, H, Katz-Salamon, M. Cardiovascular stress hyperreactivity in babies of smokers and in babies born preterm. Circulation. 2008; 118, 1848–1853.CrossRefGoogle ScholarPubMed
13.Johansson, S, Norman, M, Legnevall, L, et al. Increased catecholamines and heart rate in children with low birth weight: perinatal contributions to sympathoadrenal overactivity. J Intern Med. 2007; 261, 480–487.CrossRefGoogle ScholarPubMed
14.Bonamy, AK, Martin, H, Jorneskog, G, Norman, M. Lower skin capillary density, normal endothelial function and higher blood pressure in children born preterm. J Intern Med. 2007; 262, 635–642.CrossRefGoogle ScholarPubMed
15.Chapman, N, Mohamudally, A, Cerutti, A, et al. Retinal vascular network architecture in low-birth-weight men. J Hypertens. 1997; 15, 1449–1453.CrossRefGoogle ScholarPubMed
16.Kistner, A, Jacobson, L, Jacobson, SH, Svensson, E, Hellstrom, A. Low gestational age associated with abnormal retinal vascularization and increased blood pressure in adult women. Pediatr Res. 2002; 51, 675–680.CrossRefGoogle ScholarPubMed
17.Mitchell, P, Liew, G, Rochtchina, E, et al. Evidence of arteriolar narrowing in low-birth-weight children. Circulation. 2008; 118, 518–524.CrossRefGoogle ScholarPubMed
18.Edstedt Bonamy, AK, Bengtsson, J, Nagy, Z, De Keyzer, H, Norman, M. Preterm birth and maternal smoking in pregnancy are strong risk factors for aortic narrowing in adolescence. Acta Paediatr. 2008; 97, 1080–1085.CrossRefGoogle ScholarPubMed
19.Singhal, A, Kattenhorn, M, Cole, TJ, Deanfield, J, Lucas, A. Preterm birth, vascular function, and risk factors for atherosclerosis. Lancet. 2001; 358, 1159–1160.CrossRefGoogle ScholarPubMed
20.Nwasokwa, ON, Weiss, M, Gladstone, C, Bodenheimer, MM. Effect of coronary artery size on the prevalence of atherosclerosis. Am J Cardiol. 1996; 78, 741–746.CrossRefGoogle ScholarPubMed
21.Hellstrom, A, Perruzzi, C, Ju, M, et al. Low IGF-1 suppresses vegf-survival signaling in retinal endothelial cells: direct correlation with clinical retinopathy of prematurity. Proc Natl Acad Sci U S A. 2001; 98, 5804–5808.CrossRefGoogle ScholarPubMed
22.Hellstrom, A, Engstrom, E, Hard, AL, et al. Postnatal serum insulin-like growth factor 1 deficiency is associated with retinopathy of prematurity and other complications of premature birth. Pediatrics. 2003; 112, 1016–1020.CrossRefGoogle ScholarPubMed
23.Hellstrom, A, Hard, AL, Niklasson, A, Svensson, E, Jacobsson, B. Abnormal retinal vascularisation in preterm children as a general vascular phenomenon. Lancet. 1998; 352, 1827.CrossRefGoogle ScholarPubMed
24.Langille, BL, Brownlee, RD, Adamson, SL. Perinatal aortic growth in lambs: relation to blood flow changes at birth. Am J Physiol. 1990; 259, H1247–H1253.Google ScholarPubMed
25.Marsal, K, Persson, PH, Larsen, T, et al. Intrauterine growth curves based on ultrasonically estimated foetal weights. Acta Paediatr. 1996; 85, 843–848.CrossRefGoogle ScholarPubMed
26.Chisalita, SI, Johansson, GS, Liefvendahl, E, Back, K, Arnqvist, HJ. Human aortic smooth muscle cells are insulin resistant at the receptor level but sensitive to IGF1 and IGF2. J Mol Endocrinol. 2009; 43, 231–239.CrossRefGoogle ScholarPubMed
27.Colao, A. The GH–IGF-I axis and the cardiovascular system: clinical implications. Clin Endocrinol (Oxf). 2008; 69, 347–358.CrossRefGoogle ScholarPubMed
28.Bendeck, MP, Langille, BL. Rapid accumulation of elastin and collagen in the aortas of sheep in the immediate perinatal period. Circ Res. 1991; 69, 1165–1169.CrossRefGoogle ScholarPubMed
29.Wagenseil, JE, Ciliberto, CH, Knutsen, RH, et al. Reduced vessel elasticity alters cardiovascular structure and function in newborn mice. Circ Res. 2009; 104, 1217–1224.CrossRefGoogle ScholarPubMed
30.Burkhardt, T, Matter, CM, Lohmann, C, et al. Decreased umbilical artery compliance and IGF-1 plasma levels in infants with intrauterine growth restriction – implications for fetal programming of hypertension. Placenta. 2009; 30, 136–141.CrossRefGoogle ScholarPubMed
31.Sesso, R, Franco, MC. Abnormalities in metalloproteinase pathways and IGF-I axis: a link between birth weight, hypertension, and vascular damage in childhood. Am J Hypertens. 2010; 23, 6–11.CrossRefGoogle Scholar
32.Brodszki, J, Lanne, T, Marsal, K, Ley, D. Impaired vascular growth in late adolescence after intrauterine growth restriction. Circulation. 2005; 111, 2623–2628.CrossRefGoogle ScholarPubMed
33.Ley, D, Stale, H, Marsal, K. Aortic vessel wall characteristics and blood pressure in children with intrauterine growth retardation and abnormal foetal aortic blood flow. Acta Paediatr. 1997; 86, 299–305.CrossRefGoogle ScholarPubMed
34.Engstrom, E, Niklasson, A, Wikland, KA, Ewald, U, Hellstrom, A. The role of maternal factors, postnatal nutrition, weight gain, and gender in regulation of serum IGF-i among preterm infants. Pediatr Res. 2005; 57, 605–610.CrossRefGoogle ScholarPubMed
35.Groves, AM, Kuschel, CA, Knight, DB, Skinner, JR. Does retrograde diastolic flow in the descending aorta signify impaired systemic perfusion in preterm infants? Pediatr Res. 2008; 63, 89–94.CrossRefGoogle ScholarPubMed
36.Gardiner, H, Brodszki, J, Eriksson, A, Marsal, K. Volume blood flow estimation in the normal and growth-restricted fetus. Ultrasound Med Biol. 2002; 28, 1107–1113.CrossRefGoogle ScholarPubMed
37.Hovi, P, Turanlahti, M, Strang-Karlsson, S, et al. Intima-media thickness and flow-mediated dilatation in the Helsinki study of very low birth weight adults. Pediatrics. 2011; 127, e304–e311.CrossRefGoogle ScholarPubMed
38.Bonamy, AK, Andolf, E, Martin, H, Norman, M. Preterm birth and carotid diameter and stiffness in childhood. Acta Paediatr. 2008; 97, 434–437.CrossRefGoogle ScholarPubMed
39.Oren, A, Vos, LE, Bos, WJ, et al. Gestational age and birth weight in relation to aortic stiffness in healthy young adults: two separate mechanisms? Am J Hypertens. 2003; 16, 76–79.CrossRefGoogle ScholarPubMed
40.Norman, M. Preterm birth – an emerging risk factor for adult hypertension? Semin Perinatol. 2010; 34, 183–187.CrossRefGoogle ScholarPubMed
41.Lawlor, DA, Hubinette, A, Tynelius, P, et al. Associations of gestational age and intrauterine growth with systolic blood pressure in a family-based study of 386,485 men in 331,089 families. Circulation. 2007; 115, 562–568.CrossRefGoogle Scholar
42.Kistner, A, Celsi, G, Vanpee, M, Jacobson, SH. Increased systolic daily ambulatory blood pressure in adult women born preterm. Pediatr Nephrol. 2005; 20, 232–233.CrossRefGoogle ScholarPubMed
43.Singhal, A, Cole, TJ, Lucas, A. Early nutrition in preterm infants and later blood pressure: Two cohorts after randomised trials. Lancet. 2001; 357, 413–419.CrossRefGoogle ScholarPubMed