Preterm birth and maternal smoking in pregnancy are strong risk factors for aortic narrowing in adolescence

Department of Woman and Child Health, Karolinska Institutet, Stockholm, Sweden.
Acta Paediatrica (Impact Factor: 1.84). 09/2008; 97(8):1080-5. DOI: 10.1111/j.1651-2227.2008.00890.x
Source: PubMed

ABSTRACT Preterm transition from foetal to neonatal circulation might permanently alter aortic growth and development. To test this hypothesis, we measured aortic dimensions in adolescents born very preterm.
Eighty-six healthy 15-year-old subjects were studied; 45 born very preterm at an average gestational age of 28 weeks (birth weight < 1500 g) and 41 controls born at term. Using a pulse-gated Fiesta sequence on a 1.5T MR-scanner, 25 images were collected within the heart cycle at several levels of the descending aorta. End-diastolic cross-sectional areas were semi-automatically calculated using an active contour model.
Subjects born preterm had narrower aortic lumen. The difference was 16% in the thoracic and 19% in the abdominal aorta after adjustment for body surface area and gender (p < 0.001). Maternal smoking in pregnancy was also found to be an independent risk factor for aortic narrowing in the offspring (difference 10%-13% throughout the aorta vs. offspring to nonsmoking mothers). Adolescents born preterm had higher systolic and diastolic blood pressures; however, blood pressures did not correlate with aortic size or maternal smoking during pregnancy.
Very preterm birth and exposure to maternal smoking in foetal life are independent and strong risk factors for general aortic narrowing 15 years after birth.

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    • "Differently from Anna-Karin et al., we have only evaluated term newborns, by considering all the parameter able to influence the relationship. At a linear analysis, smoking increased abdominal aorta intima-media thickness [24], probably through endocrine modifications, involving serum insulin-like growth factor-I (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP-3) levels and actions [23] or by inducing a long-lasting " reprogramming " of the blood pressure control mechanisms [25], but the evaluation was not confirmed after adjustment for confounding variables. Nevertheless, as the hypothesis of Anna-Karin et al. about "
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