Preterm birth attenuates association between low birth weight and endothelial dysfunction

Circulation. 2003 Aug 26;108(8):996-1001. doi: 10.1161/01.CIR.0000085069.09770.3D. Epub 2003 Aug 18.


Background: Low birth weight predisposes to later coronary disease. To further elucidate the mechanisms behind this association and their timing, vascular endothelial function-a key factor in early pathophysiology of atherosclerosis-was studied in 54 infants born either before the third trimester or at term.

Methods and results: All subjects were studied at 3 months of postnatal age. A laser-Doppler technique was used to measure skin perfusion before and after transdermal iontophoresis of acetylcholine (ACh; an endothelium-dependent vasodilator). In infants born at term (n=19; birth weight range: 2230 to 4205 g), maximum perfusion after ACh was 109+/-8 perfusion units (PU, mean+/-SEM) in normal-birth weight controls compared with 56+/-13 PU among those who had been small for gestational age at birth (P<0.01). In infants born preterm (n=35; birth weight range, 722 to 1868 g), ACh induced similar perfusion responses among subjects appropriate for gestational age (113+/-16 PU) and in those small for gestational age at birth (109+/-19 PU).

Conclusions: Impairment in human endothelial function associated with low birth weight occurs or emerges late in pregnancy. Very preterm birth attenuates this association. Different gene-environment interactions in the third trimester may contribute to this finding.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetylcholine / pharmacology
  • Birth Weight
  • Blood Pressure / physiology
  • Endothelium, Vascular / drug effects
  • Endothelium, Vascular / physiology*
  • Endothelium, Vascular / physiopathology
  • Female
  • Gestational Age
  • Humans
  • Infant
  • Infant, Low Birth Weight / physiology*
  • Infant, Newborn
  • Infant, Premature / physiology*
  • Infant, Small for Gestational Age / physiology
  • Infant, Very Low Birth Weight / physiology*
  • Laser-Doppler Flowmetry
  • Male
  • Pregnancy
  • Pregnancy Trimester, Third
  • Reference Values
  • Regional Blood Flow / drug effects
  • Sex Factors
  • Skin / blood supply
  • Vasodilation / drug effects
  • Vasodilation / physiology
  • Vasodilator Agents / pharmacology


  • Vasodilator Agents
  • Acetylcholine