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Cited by 38Birth, Development, and HealthInfant Development and Preterm CareNeonatal Respiratory Health Research

The Long-Term Effect of Preterm Birth on Renal Function: A Meta-Analysis

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Heo, Ju Sun, Lee, Jiwon M.·2021·International Journal of Environmental Research and Public Health
DOI 10.3390/ijerph18062951PMC PMC8001027
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Abstract

The preterm-born adult population is ever increasing following improved survival rates of premature births. We conducted a meta-analysis to investigate long-term effects of preterm birth on renal function in preterm-born survivors. We searched PubMed and EMBASE to identify studies that compared renal function in preterm-born survivors and full-term-born controls, published until 2 February 2019. A random effects model with standardized mean difference (SMD) was used for meta-analyses. Heterogeneity of the studies was evaluated using Higgin’s I2 statistics. Risk of bias was assessed using the Newcastle–Ottawa quality assessment scale. Of a total of 24,388 articles screened, 27 articles were finally included. Compared to full-term-born controls, glomerular filtration rate and effective renal plasma flow were significantly decreased in preterm survivors (SMD −0.54, 95% confidence interval (CI), −0.85 to −0.22, p = 0.0008; SMD −0.39, 95% CI, −0.74 to −0.04, p = 0.03, respectively). Length and volume of the kidneys were significantly decreased in the preterm group compared to the full-term controls (SMD −0.73, 95% CI, −1.04 to −0.41, p < 0.001; SMD −0.82, 95% CI, −1.05 to −0.60, p < 0.001, respectively). However, serum levels of blood urea nitrogen, creatinine, and cystatin C showed no significant difference. The urine microalbumin to creatinine ratio was significantly increased in the preterm group. Both systolic and diastolic blood pressures were also significantly elevated in the preterm group, although the plasma renin level did not differ. This meta-analysis demonstrates that preterm-born survivors may be subject to decreased glomerular filtration, increased albuminuria, decreased kidney size and volume, and hypertension even though their laboratory results may not yet deteriorate.

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  • The long-term consequences of prematurity are multisystemic, extending well beyond the cardiovascular domain.

    “Adult metabolic and renal outcomes further reinforce the understanding that the long-term consequences of prematurity are multisystemic, extending well beyond the cardiovascular domain [107,108,109].”

    From Placental Pathophysiology and Developmental Programming of Adult Cardiometabolic Risk: A Narrative Review of Pregnancy Exposures (2026) · cites this paper as [109]

    The Discussion (no page given) reports reduced renal function and higher blood pressure in preterm-born survivors, supporting long-term effects beyond the cardiovascular domain. The study included follow-up into adulthood, but its analysis does not establish adult metabolic outcomes; those appear only in titles in the References. (LLM, conf=0.84)

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References 65 · Cited by 38

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Authors
Heo, J. S., & Lee, J. M.
Affiliations
  • Korea University (KR)
  • Chungnam National University (KR)
Corresponding author
Lee, Jiwon M.
ORCID
Venue
International Journal of Environmental Research and Public Health
Publisher
MDPI AG
Published
2021-03-13
Volume
18
Issue
6
Pages
2951
ISSN
1660-4601 (ISSN-L)
DOI
10.3390/ijerph18062951
PMC
PMC8001027
OpenAlex
W3138372340
Cited by
38
References
65
Citations by year
2026: 10 · 2025: 6 · 2024: 5 · 2023: 6 · 2022: 8 · 2021: 3
FWCI
1.33
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Environmental Research and Public Health (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
National Research Foundation of Korea (2020R1I1A1A01073697)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
Keywords
preterm birth, renal function, glomerular filtration rate, effective renal plasma flow, kidney size, albuminuria, hypertension, plasma renin, cystatin C, long-term outcomes
MeSH terms
Adult, Blood Pressure, Female, Glomerular Filtration Rate, Humans, Hypertension, Infant, Newborn, Kidney, Pregnancy, Premature Birth

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