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International Journal of Pediatrics
Volume 2010, Article ID 280402, 10 pages
http://dx.doi.org/10.1155/2010/280402
Clinical Study

The Long-Term Effects of Prematurity and Intrauterine Growth Restriction on Cardiovascular, Renal, and Metabolic Function

1Perinatal Research, Kolling Institute of Medical Research, The University of Sydney, Royal North Shore Hospital, NSW 2065, Australia
2Department of Obstetrics, Gynecology and Neonatology , Royal North Shore Hospital, NSW 2065, Australia
3Neonatal Pediatrics, North Shore Private Hospital, Westbourne Street, St Leonards, NSW 2065, Australia
4Biostatistics, Sydney School of Public Health, The University of Sydney, NSW 2006, Australia
5Department of Renal Medicine, Royal North Shore Hospital, NSW 2065, Australia

Received 10 June 2010; Revised 28 July 2010; Accepted 20 October 2010

Academic Editor: Frank Bloomfield

Copyright © 2010 Patricia Y. L. Chan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To determine relative influences of intrauterine growth restriction (IUGR) and preterm birth on risks of cardiovascular, renal, or metabolic dysfunction in adolescent children. Study Design. Retrospective cohort study. 71 periadolescent children were classified into four groups: premature small for gestational age (SGA), premature appropriate for gestational age (AGA), term SGA, and term AGA. Outcome Measures. Systolic blood pressure (SBP), augmentation index (Al), glomerular filtration rate (GFR) following protein load; plasma glucose and serum insulin levels. Results. SGA had higher SBP (average 4.6 mmHg) and lower GFR following protein load (average 28.5 mL/min/1.73 m2) than AGA. There was no effect of prematurity on SBP ( ) or GFR ( ). Both prematurity and SGA were associated with higher AI (average 9.7%) and higher serum insulin levels 2 hr after glucose load (average 15.5 mIU/L) than all other groups. Conclusion. IUGR is a more significant risk factor than preterm birth for later systolic hypertension and renal dysfunction. Among children born preterm, those who are also SGA are at increased risk of arterial stiffness and metabolic dysfunction.