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Cited by 108Birth, Development, and HealthNeonatal Respiratory Health ResearchInfant Development and Preterm Care

Impact of the Vulnerable Preterm Heart and Circulation on Adult Cardiovascular Disease Risk

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Lewandowski, Adam J., Levy, Philip T., Bates, Melissa L., McNamara, Patrick J., Nuyt, Anne Monique, Goss, Kara N.·2020·Hypertension
DOI 10.1161/hypertensionaha.120.15574PMC PMC7480939
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Abstract

Preterm birth accounts for over 15 million global births per year. Perinatal interventions introduced since the early 1980s, such as antenatal glucocorticoids, surfactant, and invasive ventilation strategies, have dramatically improved survival of even the smallest, most vulnerable neonates. As a result, a new generation of preterm-born individuals has now reached early adulthood, and they are at increased risk of cardiovascular diseases. To better understand the sequelae of preterm birth, cardiovascular follow-up studies in adolescents and young adults born preterm have focused on characterizing changes in cardiac, vascular, and pulmonary structure and function. Being born preterm associates with a reduced cardiac reserve and smaller left and right ventricular volumes, as well as decreased vascularity, increased vascular stiffness, and higher pressure of both the pulmonary and systemic vasculature. The purpose of this review is to present major epidemiological evidence linking preterm birth with cardiovascular disease; to discuss findings from clinical studies showing a long-term impact of preterm birth on cardiac remodeling, as well as the systemic and pulmonary vascular systems; to discuss differences across gestational ages; and to consider possible driving mechanisms and therapeutic approaches for reducing cardiovascular burden in individuals born preterm.

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  • Preterm birth is associated with higher blood pressure, altered vascular development, and distinct cardiac structure and function in adulthood.

    “Preterm birth has been associated with higher BP, altered vascular development, and distinct cardiac structure and function in adulthood, providing a coherent clinical narrative linking early delivery to later cardiovascular vulnerability [105].”

    From Placental Pathophysiology and Developmental Programming of Adult Cardiometabolic Risk: A Narrative Review of Pregnancy Exposures (2026) · cites this paper as [105]

  • Disruption of late-gestation cardiovascular development, combined with altered postnatal adaptation in the preterm circulation, may result in persistent differences in haemodynamics and myocardial structure that remain evident in adulthood.

    “Together, these findings support the view that disruption of late-gestation cardiovascular development, combined with altered postnatal adaptation in the preterm circulation, may result in persistent differences in haemodynamics and myocardial structure that remain evident in adulthood.”

    From Placental Pathophysiology and Developmental Programming of Adult Cardiometabolic Risk: A Narrative Review of Pregnancy Exposures (2026) · cites this paper as [105]

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Authors
Lewandowski, A. J., Levy, P. T., Bates, M. L., McNamara, P. J., Nuyt, A. M., & Goss, K. N.
Affiliations
  • Boston Children's Hospital (US)
  • University of Iowa (US)
  • Centre Hospitalier Universitaire Sainte-Justine (CA)
  • University of Wisconsin–Madison (US)
Corresponding author
Lewandowski, Adam J.
ORCID
Venue
Hypertension
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2020-10
Volume
76
Issue
4
Pages
1028-1037
ISSN
  • 0194-911X (ISSN-L)
  • 1524-4563
DOI
10.1161/hypertensionaha.120.15574
PMC
PMC7480939
OpenAlex
W3053899182
Cited by
108
References
79
Citations by year
2026: 15 · 2025: 16 · 2024: 23 · 2023: 21 · 2022: 16 · 2021: 16 · 2020: 1
FWCI
2.97
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Hypertension (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Funders
  • American Heart Association (18CDA34110440)
  • Heart and Stroke Foundation of Canada
  • British Heart Foundation (FS/18/3/33292)
  • Canadian Institutes of Health Research (399001, 313082)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
Keywords
preterm birth, cardiovascular risk, cardiac remodeling, left ventricular volume, vascular stiffness, pulmonary hypertension, pulmonary vascular function, gestational age, antenatal glucocorticoids, surfactant therapy, neonatal intensive care, long-term cardiovascular outcomes, adolescents and young adults
MeSH terms
Cardiovascular Diseases, Heart, Humans, Hypertension, Infant, Newborn, Infant, Premature, Risk Factors, Premature Birth, Vascular Stiffness

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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