The effects of preterm birth and its antecedents on the cardiovascular system

Acta Obstet Gynecol Scand. 2016 Jun;95(6):652-63. doi: 10.1111/aogs.12880. Epub 2016 Mar 31.

Abstract

Introduction: Preterm birth occurs in approximately 10% of all births worldwide. It prematurely exposes the developing cardiovascular system to the hemodynamic transition that occurs at birth and to the subsequent functional demands of life ex utero. This review describes the current knowledge of the effects of preterm birth, and some of its common antecedents (chorioamnionitis, intra-uterine growth restriction, and maternal antenatal corticosteroid administration), on the structure of the myocardium.

Material and methods: A thorough literature search was conducted for articles relating to how preterm birth, and its antecedents, affect development of the heart. Given that sheep are an excellent model for the studies of cardiac development, this review has focused on experimental studies in sheep as well as clinical findings.

Results: Our review of the literature demonstrates that individuals born preterm are at an increased risk of cardiovascular disease later in life, including increased mean arterial pressure, abnormally shaped and sub-optimally performing hearts and changes in the vasculature. The review highlights how antenatal corticosteroids, intra-uterine growth restriction, and exposure to chorioamnionitis also have the potential to impact cardiac growth in the preterm newborn.

Conclusions: Preterm birth and its common antecedents (antenatal corticosteroids, intra-uterine growth restriction, and chorioamnionitis) have the potential to adversely impact cardiac structure immediately following birth and in later life.

Keywords: Preterm birth; antenatal corticosteroids; blood vessels; chorioamnionitis; developmental programming; heart; intra-uterine growth restriction.

Publication types

  • Review
  • Comment

MeSH terms

  • Adrenal Cortex Hormones
  • Animals
  • Cardiovascular System
  • Chorioamnionitis*
  • Fetal Growth Retardation*
  • Humans
  • Infant, Newborn
  • Premature Birth
  • Sheep, Domestic

Substances

  • Adrenal Cortex Hormones