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More evidence linked moderate and late preterm birth with poor long-term cardiometabolic outcomes, though it remains unclear whether early-life interventions would be beneficial in childhood and adulthood, according to a longitudinal cohort study.

By ages 3 to 12 years, children who had been born moderately preterm (<34 weeks of gestation) and late preterm (34 to 36 weeks of gestation) had elevated cardiometabolic risk factors compared with those born full term, reported epidemiologist Laura Anderson, PhD, of McMaster University in Hamilton, Ontario, and colleagues.

Each additional gestational week was associated with a small decrease in a cardiometabolic risk score that takes into account standardized waist circumference, triglycerides, glucose, systolic blood pressure, and HDL cholesterol levels, the authors noted in .

"Because the CMR [cardiometabolic risk] score tracks risk from childhood into adulthood, early preventive evaluation and CMR monitoring beginning early in childhood is warranted for preterm-born children," Anderson's group concluded.

Other researchers had previously reported that people born late preterm were at increased risk of hypertension and other cardiometabolic risk factors as both children and adults.

"All of these studies emphasize the need to optimize maternal health and prevent preterm deliveries, even when they occur relatively late in gestation," wrote Lauren Iacono, DO, and Molly Regelmann, MD, both of the Children's Hospital at Montefiore, Albert Einstein College of Medicine, in New York City, in an .

"Future controlled studies are necessary to understand whether early screening and therapeutic interventions directed at those born late preterm have the ability to reduce the risk and burden of cardiometabolic disease," the duo urged.

For their study, Anderson and colleagues analyzed children born in Ontario in 2006 to 2014, who were recruited into a longitudinal cohort study. Children were excluded if they had conditions affecting growth, any acute or chronic conditions other than asthma and high-functioning autism, severe developmental delay, or families who didn't speak English.

The final cohort included 1,742 kids averaging 5.6 years of age; 54.6% were boys.

Birth was classified as full term (at least 39 weeks' gestation) for 60.6%, early term (37-38 weeks' gestation) for 26.1%, late preterm (34-36 weeks' gestation) for 8.3%, and moderately preterm (<34 weeks' gestation) for 5.0%.

Early-term birth was not associated with cardiometabolic health.

A secondary analysis by size for gestational age also showed no relationship with overall cardiometabolic outcomes. However, larger babies tended to have higher waist circumference as children, whereas smaller babies grew to have thinner waists.

While Anderson and colleagues used a multivariable adjustment process that pooled administrative medical records, cohort study questionnaire data, and physical measures, they cautioned that residual confounding and selection bias were possible in their analyses, and that more data are needed from diverse populations.

Beyond the present study, Iacono and Regelmann noted that there is no standard CMR score for children, and that various groups may employ different measures in their own scores. "Standardizing and validating CMR scores would strengthen future studies and allow for analyses to be conducted across studies," they suggested.

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