Lower insulin sensitivity remains a feature of children born very preterm

The extremely preterm young adult - State of the art

Recently several studies have reported adult outcomes for individuals born at extremely low gestations, although they tend to be included as part of slightly more mature populations. The growth in collaborative studies allows greater confidence in the identification of persisting risk and allows us to have confidence in the likely outcomes in more contemporary cohorts. This review shows the persistence of adverse outcomes through to adult life and includes a range of outcomes including all body systems evaluated. Nonetheless adult outcomes demonstrate that most survivors appear to be free of major disabling conditions and demonstrate good participation in society. Several studies have reported outcomes in the third decade, but subsequent ageing trajectories have not yet been defined. The stability of many of the outcomes evaluated over childhood into adult life and the lack of improvement in prevalence of childhood impairments found in contemporary cohorts indicates persisting levels of risk.

Postnatal Expression Profile of MicroRNAs Associated with Cardiovascular Diseases in 3- to 11-Year-Old Preterm-Born Children

(1) Background: Preterm-born children have an increased cardiovascular risk with the first clinical manifestation during childhood and/or adolescence. (2) Methods: The occurrence of overweight/obesity, prehypertension/hypertension, valve problems or heart defects, and postnatal microRNA expression profiles were examined in preterm-born children at the age of 3 to 11 years descending from preterm prelabor rupture of membranes (PPROM) and spontaneous preterm birth (PTB) pregnancies. The whole peripheral blood gene expression of 29 selected microRNAs associated with cardiovascular diseases was the subject of our interest. (3) Results: Nearly one-third of preterm-born children (32.43%) had valve problems and/or heart defects. The occurrence of systolic and diastolic prehypertension/hypertension was also inconsiderable in a group of preterm-born children (27.03% and 18.92%). The vast majority of children descending from either PPROM (85.45%) or PTB pregnancies (85.71%) had also significantly altered microRNA expression profiles at 90.0% specificity. (4) Conclusions: Postnatal microRNA expression profiles were significantly influenced by antenatal and early postnatal factors (gestational age at delivery, birth weight of newborns, and condition of newborns at the moment of birth). These findings may contribute to the explanation of increased cardiovascular risk in preterm-born children. These findings strongly support the belief that preterm-born children should be dispensarized for a long time to have access to specialized medical care.