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Preterm babies face metabolic challenges later in life

BMJ 2007; 334 doi: (Published 24 May 2007) Cite this as: BMJ 2007;334:1081

For babies born at term, low birth weight is associated with metabolic disadvantages that can lead to obesity, type 2 diabetes, and cardiovascular disease later in life. Researchers now confirm that premature babies with very low birth weight face the same kind of metabolic challenges.

In a comparative study from Finland, young adults born at an average gestational age of 29 weeks and weighing less than 1500 g had worse insulin resistance, higher serum concentrations of glucose two hours after a glucose load, and higher blood pressure than similar young adults who had been born at term. The differences were significant, potentially important clinically, and not explained by differences in body mass index or body composition. The cohort with very low birth weight had a mean systolic blood pressure nearly 5 mm Hg higher than controls (95% CI 2.1 to 7.4). They were also significantly shorter (by 5.3 cm in women and 5.9 cm in men).

These adults were born 20 years ago. Improvements in neonatal care mean that an increasing proportion of very low birthweight babies will survive to adulthood. They may well benefit from early lifestyle advice to help them avoid the consequences of glucose dysregulation and insulin resistance, say the authors.


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