Preterm Birth and Risk of Heart Failure Up to Early Adulthood
Key result
Extremely preterm birth linked to ~17-fold higher risk of incident HF vs. term birth.
- RR 17.0
- 95% CI 7.96-36.3
- n=2,665,542
Why the study?
Preterm birth has been associated with altered cardiac structure and increased cardiovascular mortality in small studies, but its association with incident heart failure in children and young adults is unclear.
Does preterm birth increase the risk of incident heart failure in children and young adults?
Population
2,665,542 individuals born in Sweden from 1987 to 2012
Comparison
Preterm birth (<28, 28-31, 32-36 weeks) vs term birth (≥37 weeks)
Design
Register-based cohort study
Follow-up
Median 13.1 years
Authors
Discussion
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Member takes
Implication
Preterm birth before 32 weeks of gestation is strongly associated with an increased risk of incident heart failure in childhood and young adulthood.
Key Points
- To determine whether preterm birth is associated with an increased risk of incident heart failure from childhood up to early adulthood.
- Conducted a nationwide register-based cohort study of 2,665,542 individuals born in Sweden from 1987 to 2012, followed from 1 year of age to December 31, 2013 (median follow-up 13.1 years; 34.8 million person-years).
- Identified incident heart failure cases via the National Patient Register and Cause of Death Register, analyzing associations with Poisson regression adjusted for maternal, socioeconomic, and familial cardiovascular factors.
- Identified 501 total cases of heart failure; after excluding 52,512 individuals with congenital malformations (n = 196 cases), 305 incident cases remained (0.88 per 100,000 person-years).
- Compared with full-term birth (≥37 weeks), adjusted relative risk of heart failure was 17.0 (95% CI: 7.96 to 36.3) for extremely preterm birth (<28 weeks) and 3.58 (95% CI: 1.57 to 8.14) for very preterm birth (28 to 31 weeks).
- Moderately preterm birth (32 to 36 weeks) showed no statistically significant increase in risk compared to full-term birth (relative risk: 1.36; 95% CI: 0.87 to 2.13).
Study Design
Type
Cohort (n=2,665,542)
Multicenter
Yes
Structured PICO
Does preterm birth increase the risk of incident heart failure in children and young adults?
P
Population
2,665,542 individuals born in Sweden from 1987 to 2012, followed for a median of 13.1 years to assess the risk of incident heart failure.
E
Exposure
Preterm birth (extremely preterm <28 weeks, very preterm 28 to 31 weeks, moderately preterm 32 to 36 weeks)
C
Comparator
Individuals born at term (≥37 weeks' gestation)
O
Outcome
Diagnosis of HF in the National Patient Register or the Cause of Death Registerhard clinical
Main Result
Relative Risk: 17 (95% CI 7.96–36.3)
Preterm birth before 32 weeks of gestation is strongly associated with an increased risk of incident heart failure in childhood and young adulthood.
Cite This Study
Carr et al. (2017) conducted a cohort in Heart failure (n=2,665,542). Preterm birth vs. Term birth (≥37 weeks' gestation) was evaluated on Diagnosis of heart failure in the National Patient Register or the Cause of Death Register (RR 17.0, 95% CI 7.96-36.3). Extremely preterm birth (<28 weeks) was strongly associated with an increased risk of incident heart failure compared with term birth (RR 17.0; 95% CI 7.96-36.3).