Abstract
Low birth weight has been associated with chronic low-grade inflammation and later
cardiovascular disease. Whether this is related to low birth weight due to premature
birth, being born small for gestational age (birth weight below the 10th percentile for gestational age) or variations in postnatal growth patterns is unknown.
The objective of this study was to explore the impact of fetal growth restriction
versus low birth weight due to prematurity on inflammatory status in later life. We
investigated systemic markers of cell-mediated immune activation, kynurenine/tryptophan
ratio and high-sensitive CRP (hs-CRP), in two population-based cohorts of children
aged 10 and 17 years, who were born preterm (gestational age ≤ 28 weeks) or with an
extremely-low-birth weight (< 1000 g) (n = 4). The controls were sex-and age-matched term-born with appropriate for gestational
age birth weight children (n = 75). Children born premature and small for gestational age had higher Kyn/Trp and
hs-CRP compared to both age-matched preterms with appropriate for gestational age
birth weight (p = 0.01 and p = 0.002, for Kyn/Try ratio and CRP respectively) and controls (p < 0.001 and p = 0.001). No significant differences in inflammatory markers were observed between
appropriate for gestational age preterms and controls. Our observations suggest that
the chronic low-grade immune activation observed in adults born with a low birth weight
may be related to fetal growth restriction rather than low birth weight due to prematurity.
Keywords
Cardiovascular disease - birth weight - small for gestational age - kynurenines
