Increased cardiovascular risk in obese children born with low weight – Health and Medicine

by time news

A Clínic/Idibaps study suggests that birth weight should be added to the rest of the factors that are already taken into account in the clinic. Low birth weight is understood to be below the 10th percentile of the weight that would touch for gestation time or less than 2.5 kilos if they are not premature.

Obesity in adulthood enhances the increased cardiovascular risk that, from the outset, people born with low weight have (below the 10th percentile of the weight that they would have due to gestational time or less than 2.5 kilos if they are not premature ), according to a new study in this regard led by the Hospital Clínic-Idibaps in Barcelona.

Fátima Crispi, a senior specialist at the BCNatal Maternal-Fetal Medicine Service of the Hospital Clínic and the Sant Joan de Déu Maternal-Children’s Hospital and a researcher in the Idibaps Fetal and Perinatal Medicine group, who has coordinated this work, explains to this newspaper that Many studies carried out with large cohorts in the 1990s in Europe and America already know that being born with low risk increases the risk of mortality from cardiovascular disease in adulthood.

The hypothesis, he indicates, is that during fetal development the placenta has not worked well and that has dealt a first blow to the heart, which is already a little touched (rounder and hypertrophic). If the child, then an adult, leads a healthy life, it does not have to be a problem, but if he has hypertension or other added risk factors, he must know that his heart may react worse than usual because, in that case, he would receive a second hit. That is, the heart adapts once but in the second it may not be able to do so.

The new study, published in the European Heart Journal – Cardiovascular Imaging, demonstrates just that: having a low birth weight limits the ability of the heart to adapt when there is another cardiovascular risk factor such as obesity. That is, in this case, he does not have the ability to increase his muscle mass and size to be able to pump blood; therefore, it works worse.

The work, with the participation of the University of Lyon, in France, and the Pompeu Fabra University of Barcelona and with funding from the FIS of the Carlos III Health Institute, now continues to analyze another added risk factor such as tobacco consumption and to continue observing the evolution of the people in the sample analyzed (whether those who were born with low weight have more cardiovascular disease, more admissions for this cause, etc.).

The problem of low birth weight is not something exceptional: it is estimated that they represent 10% of births. And it is known that those affected are up to three times more likely to have a myocardial infarction and also a greater risk of hypertension, stroke, diabetes or metabolic syndrome.

The Clínic/Ibaps team previously published in JAMA Cardiology what cardiac changes occur in adults born with low weight. They are very exaggerated: cardiomegaly and hypertrophy, which when children are 5 years old are similar, but less accentuated and, when they reach 12 years old, they are maintained. In the case of adults, this study has shown that, along with other risk factors, there are changes in the right ventricle; it is more dilated and the base is more curved. “It is similar to that of athletes who have made a lot of effort,” Crispi said then.

In their new study they have taken into account the same cohort: 155 adults, half with low birth weight and half with adequate fetal growth. Cardiac magnetic resonance imaging is available from all of them. In this second work, they have analyzed the interaction between birth weight and the degree of central obesity (defined by the waist-hip ratio) using a complex analysis method of the structure of the heart (statistical shape analysis).

This sample has allowed them to compare and observe that low birth weight conditions an atypical response to obesity in adulthood: the heart, which should hypertrophy (make more muscle mass and dilate) to be able to work harder and pump more blood, does not it does and therefore works worse.

Crispi says that, as the American Society of Cardiology already does, it should be recommended that low birth weight be incorporated as another cardiovascular risk factor, along with others already accepted such as family history, tobacco use, poor diet, excess weight and obesity and high blood pressure, etc.

From the outset, he advises, the relatives of the minors affected should be warned of the increased risk and the importance of a healthy lifestyle, as well as controlling their blood pressure. And pediatricians also take it into account, in case they consider it appropriate to carry out periodic control visits. “It’s about being more aware of the risk,” she defends.

A global problem

The World Health Organization (WHO) considers low birth weight a public health problem worldwide and that it is not only an important predictor of prenatal morbidity and mortality, but also increases the risk of noncommunicable diseases, such as diabetes or cardiovascular disease, later in life.

In total, it is estimated that between 15% and 20% of children born worldwide have low birth weight, which represents more than 20 million newborns each year. However, there is considerable variability by region and even within the same country. The vast majority of cases of low birth weight occur in low- and middle-income countries, especially in the most vulnerable population groups. Carmen Fernandez

You may also like

Leave a Comment