Association between prematurity and cardiac remodelling in childhood: a cross-sectional study

Objective Compare cardiac morphology and function in childhood between children born extremely preterm and those born at term. Design Cross-sectional study of participants from previously established neonatal cohorts. Participants Ex-preterm and term born control children aged 7–12 years who were participants in studies of nutritional interventions and body composition in the neonatal period. Interventions Free-breathing, non-sedated cardiac MRI. Main outcome measures Cardiac morphology and function including ventricular indexed end-diastolic volume, ventricular indexed myocardial mass, ventricular stroke volumes and ventricular ejection fractions. Results 33 ex-preterm and 32 term-born children were included. The median (IQR) age was 10 (9–10) years. The mean (SD) gestational age of the preterm babies was 28.5 (2.2) weeks and mean (SD) birth weight was 1205 (338 g). No statistically significant differences were detected in any outcomes; however, the direction and magnitude of differences across most cardiac parameters were consistent with being smaller in the preterm group. Conclusions Contrary to published literature, we found no statistically significant differences in cardiac structure and function in young and pre-adolescent children born extremely preterm compared with those born at term. The small sample size precludes drawing firm conclusions. Further studies are needed to understand the progression of cardiac changes through adolescence and into adulthood and potential interventions to prevent adverse cardiovascular outcomes in this vulnerable population.