20 - Association of preterm birth and lower birth weight with obesity, dyslipidemia, and hyperglycemia: initial findings from the SUPERHERO registry

Poster Number: 20
Publication Number: 20.322

Margaret Murphy, University of Kentucky College of Medicine, Lexington, KY, United States; John A. Bauer, University of Kentucky College of Medicine, Lexington, KY, United States; Shupti Biswas, Cohen Children's Medical Center, Floral Park, NY, United States; Aaron M. Bridges, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Wilkesboro, NC, United States; Rachel A. Carrasquillo, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston Salem, NC, United States; Lucy D'Agostino McGowan, Wake Forest University, Winston Salem, NC, United States; Victoria Giammattei, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, winston-Salem, NC, United States; Margret Kamel, Emory University School of Medicine, Atlanta, GA, United States; Stefan G. Kiessling, Kentucky Children's Hospital, Lexington, KY, United States; Jackson T. Londeree, Emory, Atlanta, GA, United States; Caroline B. Lucas, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States; Jason Misurac, University of Iowa Stead Family Children's Hospital, Iowa City, IA, United States; Sandeep Riar, Emory University School of Medicine, Atlanta, GA, United States; Christine Sethna, Cohen Children’s Medical Center, New Hyde Park, NY, United States; Irina Viviano, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston-Salem, NC, United States; Donald J. Weaver, Levine Children's Hospital, Charlotte, NC, United States; Ikuyo Yamaguchi, Oklahoma Childrens Hospital at OU Health, Oklahoma city, OK, United States; Emily J. Yun, Emory SOM, Atlanta, GA, United States; Andrew M.. South, Wake Forest School of Medicine of Wake Forest Baptist Medical Center, Winston Salem, NC, United States

Background: Survival of premature birth in the US has steadily improved in recent decades, as has the prevalence of youth-onset hypertension. The association of early-life risk factors with development of hypertension and cardiovascular risk factors is well-established; however, little is known how these factors impact cardiovascular risk once an individual develops hypertension.  

Objective: Investigate the relationships among preterm birth (< 37 weeks gestational age), lower birth weight (LBW, < 2500 g), and small for gestational age (SGA), defined as weight below the 10^th percentile for gestational age, in relation to obesity, dyslipidemia, and hyperglycemia in youth referred to subspecialty care for hypertension disorders.  

Design/Methods: Analysis of baseline data from the Study of the Epidemiology of Pediatric Hypertension (SUPERHERO) Registry, a multisite retrospective cohort of youth referred to subspecialty care for hypertension disorders using electronic health record data. Inclusion criteria were an initial subspecialty clinic visit for hypertension disorders identified by ICD-10 codes from 1/1/2015–12/31/2021 and age < 19 years. Exclusion criteria were kidney failure on dialysis, kidney transplantation, or pregnancy by ICD-10 codes. Exposures included preterm birth, LBW, and SGA identified by ICD-10 codes. Unadjusted generalized linear models estimated the association of preterm birth and LBW with the outcomes of obesity by BMI or weight-for-length percentiles, dyslipidemia, and hyperglycemia by ICD-10 codes.  

Results:

 Of the 12,148 participants, the mean age was 11.6 ±5.2, 60% were male, 61% were White or Caucasian, 23% were Black or African American, 13% were Hispanic or Latino, and 0.7% (n=90) had preterm birth, LBW, or SGA (see Table 1). Participants with preterm birth did not have a higher risk of obesity, dyslipidemia or hyperglycemia. Participants with LBW had lower risk of obesity (RR 0.36, CI: 0.16-0.72) and a higher risk of dyslipidemia (RR 5.59, CI 1.67 to 14.0). Participants with growth restriction were not ultimately included in the analysis due to small sample size (n=16).  

 

Conclusion(s): In a large multisite cohort of youth referred for hypertension disorders, participants with LBW had a higher risk of dyslipidemia and lower risk for obesity. Preterm birth, LBW, and SGA status are likely underreported by ICD-10 codes, as it is unlikely that there is 0.7% prevalence in this population. Ongoing analyses include obtaining actual birth weight and gestational age and investigating these associations with laboratory and echocardiogram data.