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Low birth weight induces changes to the heart that persist at adult age and limits capacity for exercise

A study coordinated by researchers at BCNatal-IDIBAPS and University of Barcelona (UB), and published by the journalJAMA Cardiology, shows that people born with a low birth weight present differences in the structure and functioning of their heart and have less capacity for physical activity than other people when they are adults.

Low birth weight and cardiovascular risk

People who were born with low birth weight (those in the first decile, i.e. out of all births, the 10% of babies that were born with the lowest birth weight) experience more cardiovascular problems when they are adults. For example, they have up to three times more probabilities of suffering a myocardial infarction.

To date, the reason for this was unknown, and it was considered that it might be due to higher rates of heart attack, obesity,hypertension, stroke, diabetes or metabolic syndrome.

The research team led byDrGratacóswas the first to demonstrate, in previous studies, that an important part of the problem is the heart itself. “We saw that the hearts of children with a low birth weight present differences in function and in structure, and that these differences that appear in the fetal stage persist until adolescence”.

It was still necessary to find out whether the changes in the heart’s structure and function persist in adult age and this was what was studied in the work published inJAMA Cardiology. “It is a pioneering study, which combines highly sophisticated computerised analysis techniques to analyse the shape of the heart using magnetic resonance imaging and a stress test”, explainsMarta Sitges, director of the Institut Clínic Cardiovascular, head of the IDIBAPS Cardiac imaging group and co-author of the study.

People were selected aged between 20 and 40 years who had been born with low birth weight or with normal birth weight. To locate them, the delivery books from the Hospital de Sant Joan de Déu from 20 to 40 years ago were reviewed. Based on the date of birth and the mother’s surname, it was possible to contact some of the individuals, and the proposal was made to them to participate in the study.

Participation consisted of 158 adults, of whom 81 had been born with a low birth weight and 77 with a normal birth weight. They underwent a cardiac MRI and a stress test using a bicycle.

Differences in cardiac structure and response to stress

“The cardiac MRI showed that people who had been born with low birth weight show significant changes in theirr heart structure atadult age. Their right ventricle had a different shape”, explainsFàtima Crispi.

It also involved the participation, among others, of researchers from theInstitut Clínic Cardiovascular,theInstitut Clínic Respiratori, the IDIBAPSCardiac imagingandTranslational computation in cardiologyresearch groups and researchers from the Universitat de Barcelona, Universitat Pompeu Fabra, the Barcelona Supercomputing Center and Philips Research France. The project also benefited from the support of the Fundació La Caixa, the Carlos III Health Institute, the European Commission, CEREBRA, CIBERER and AGAUR.

Article reference:

F. Crispi, M. Rodríguez-López, G. Bernardino et al. “Exercise Capacity in Young Adults Born Small for Gestational Age”. JAMA Cardiol. July 21, 2021. doi:10.1001/jamacardio.2021.2537

F. Crispi, M. Rodríguez-López, G. Bernardino et al. “Exercise Capacity in Young Adults Born Small for Gestational Age”. JAMA Cardiol. July 21, 2021. doi:10.1001/jamacardio.2021.2537
Attached files
  • Research team. Marta Sitges, Kilian Vellvé, Fàtima Crispi, Isabel Blanco, Eduard Gratacós and Francesca Crovetto. Credit: H.Clínic
Regions: Europe, Spain
Keywords: Health, Medical


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