Prior preterm or small-for-gestational-age birth related to maternal metabolic syndrome.
OBJECTIVE
To estimate whether women who deliver small babies due to preterm birth or growth restriction have excess risk for cardiovascular disease and diabetes later in life.


METHODS
Eight years after pregnancy, we estimated the prevalence of metabolic syndrome and its components in a cohort study of women with prior preterm (preterm birth before 37 weeks, n=181) or small for gestational age ([SGA], less than the tenth percentile, n=192) births, compared with women with term births (37 or more weeks, n=306). Women delivered at Magee-Womens Hospital in Pittsburgh, Pennsylvania, and those with preeclampsia or prepregnancy diabetes or hypertension were excluded. Women underwent a structured interview and fasting blood sampling.


RESULTS
Women were, on average, 8 years postpartum and 39 years old at evaluation. Women with a prior preterm birth had higher blood pressure, triglycerides, and LDL-cholesterol compared with those in a term control group. Women with prior SGA births were leaner and more likely to smoke compared with those with term births. Women with prior preterm birth had elevated risk of metabolic syndrome, adjusted for demographic, smoking and body size factors (23% preterm compared with 17% control group; odds ratio [OR] 1.76 [1.06, 2.80]). In women with a prior preterm birth, low HDL (11% preterm compared with 5% control group; OR 2.6 [1.2, 5.2]), hypertriglyceridemia (22% compared with 14%; OR 1.9 [1.2, 2.9]), and elevated glucose (24% compared with 19%; OR 1.5 [1.0, 2.3]) accounted for this excess metabolic syndrome. In women with SGA, the only element of metabolic syndrome that was aberrant was glucose metabolism.


CONCLUSIONS
Eight years after pregnancy, women with prior preterm or SGA births had evidence of metabolic syndrome compared with women with term births. Screening and intervention in these women after pregnancy may delay or prevent disease.


METHODS
: II.
From the Departments of OB/GYN and Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania; the Magee-Womens Research Institute, Pittsburgh, Pennsylvania; and The University of Texas Health Science Center at Houston School of Public Health, Houston, Texas.
Janet M
JM
Catov
Rhiannon
R
Dodge
Jose-Miguel
JM
Yamal
James M
JM
Roberts
Linda B
LB
Piller
Roberta B
RB
Ness
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D024821:Metabolic Syndrome / Q000453:epidemiology*; D010414:Pennsylvania / Q000453:epidemiology; D011247:Pregnancy
Ann Epidemiol. 2007 Jan;17(1):36-43
16843009
JAMA. 2009 Nov 18;302(19):2104-10
19920234
Circulation. 2009 Oct 20;120(16):1640-5
19805654
BMJ. 1998 Mar 14;316(7134):834-7
9549456
J Lipid Res. 1978 Jan;19(1):65-76
202660
BMJ. 2002 Aug 17;325(7360):359
12183306
N Engl J Med. 2000 May 18;342(20):1500-7
10816189
Clin Chem. 1974 Apr;20(4):470-5
4818200
J Clin Endocrinol Metab. 1991 Mar;72(3):642-6
1997519
Lancet. 2000 Dec 16;356(9247):2066-7
11145495
Diabet Med. 1998 Jul;15(7):539-53
9686693
BMJ. 2000 Mar 25;320(7238):839-40
10731177
Pediatrics. 2007 Oct;120(4):723-33
17908758
Am J Obstet Gynecol. 2007 Dec;197(6):610.e1-7
18060950
Horm Metab Res. 2008 Dec;40(12):901-6
18726830
Med Sci Sports Exerc. 2000 Sep;32(9 Suppl):S498-504
10993420
Am J Obstet Gynecol. 1982 Dec 1;144(7):768-73
7148898
J Clin Endocrinol Metab. 2010 Aug;95(8):3711-8
20501685
Epidemiology. 2007 Nov;18(6):733-9
17917602
Am J Epidemiol. 1999 Aug 15;150(4):408-16
10453817
Clin Chem. 1972 Jun;18(6):499-502
4337382
Clin Chem. 1973 May;19(5):476-82
4703655
Epidemiology. 2005 Jul;16(4):563-9
15951676
Clin Chem. 1974 May;20(5):586-90
4363766
Lancet. 2001 Jun 23;357(9273):2002-6
11438131
J Subst Abuse. 2000;11(2):123-38
10989773
Diabetes Care. 2003 Feb;26(2):372-9
12547865
Ann Epidemiol. 2010 Aug;20(8):604-9
20609340
Atherosclerosis. 2009 Jul;205(1):244-50
19022445