Cardiovascular risk emerges earlier by birth weight and preterm birth status in the United States add health sample

Background: Preterm birth and low birth weight are associated with an increased risk of chronic conditions such as hypertension, diabetes and cardiovascular disease, which significantly contribute to increased mortality. Much of the literature supporting these assertions are from countries outside of the United States. The current study aims to explore the relationship between preterm birth and birth weight status, and cardiovascular risk emergence among young adults in the United States.

Methods: The National Longitudinal Study of Adolescent Health (Add Health) is a nationally representative sample from the United States. Survival analyses were conducted that compare the onset of high blood pressure, high cholesterol and diabetes across the sample members categorized by preterm birth and birth weight status. Body mass index was investigated for potential mediation for timing of diagnosis.

Results: Across health outcomes, there was no evidence that BMI acted as a mediator between preterm low birth weight status and the timing of diagnoses. Preterm low birth weight participants were diagnosed with diabetes approximately 12 % earlier compared to normal birth weight groups. Effect sizes for full term low birth weight were small across high cholesterol and hypertension, but not significant in this sample.

Conclusions & relevance: This analysis highlights the importance of both preterm birth and birth weight in influencing adolescent and adult health. The two components are inextricably linked and contribute significantly to comorbidity. Risk mitigation through proactive lifestyle counseling and early treatment are critical to health risk mitigation for those born early or small.