Premature babies at higher risk of heart disease

Published: 29 September 2020

Premature babies and their mothers are at higher risk of developing heart disease, but new research could change New Zealand's national guidelines for cardiovascular screening for mothers and babies.

Dr Sarah Harris, Neonatal Paediatrician, University of Otago Christchurch, has been awarded a Heart Foundation Research Fellowship to come up with real-world solutions to investigate the link between premature birth and heart disease.

"Our aim is to ensure that premature birth does not lead to a premature death later in life in these children or their mums," says Dr Harris.

"Emerging evidence shows adults who were born prematurely, and mothers who give birth to a premature baby, are at increased risk of cardiovascular disease but neither are included in our national guidelines for cardiovascular risk screening."

"Cardiovascular disease is known to originate early in life. The environment in the womb and experiences in the early post-natal period affect cardiovascular development and can alter future cardiovascular risk. The physiological changes of pregnancy, especially complicated pregnancy can further alter this risk. However, traditional prevention programmes recommend screening at middle age when vascular changes are established, cardiac function is declining and risk factors such as smoking, poor diet and lack of exercise are challenging to change," she says.

The Heart Foundation announced $4.2 million dollars of funding today for heart research and specialist training for New Zealand cardiologists in 2020, bringing the total awarded by the charity since its formation in 1968, to more than $78 million dollars.

"We have a long and proud record of research investment, which has improved the heart health of all New Zealanders for more than 50 years, but we still have much more work to do," says Heart Foundation Medical Director, Dr Gerry Devlin.

"Premature births are very common affecting 7.5 per cent of births in Aotearoa. Dr Harris' research will make a real difference to so many Kiwis," says Dr Devlin.

The birth of a premature baby may be an opportunity to review cardiovascular risk for both mother and baby and to initiate an earlier programme of risk surveillance, health education and preventative care that could have intergenerational benefit.

This research project will review the current evidence for the link between premature birth and cardiovascular disease later in life and compare cardiovascular risk in a national cohort of adults born prematurely to that in term-born peers.

"We will also compare cardiovascular risk, event rates and deaths in mothers of this cohort to see if there is a difference between those whose pregnancy was complicated by preterm delivery and those who delivered at term." 

This project is the continuation of work that Dr Harris and the New Zealand Very Low Birthweight Study team have been doing investigating differences in the structure and function of the heart after premature birth using heart ultrasound.

"This work is of particular importance to Māori, who have higher rates of premature birth and cardiovascular disease, and to ensure our cardiovascular screening programme is not missing an important risk factor contributing to premature death for women," says Dr Harris.

"The Heart Foundation Fellowship means a great deal as it gives me the opportunity to raise awareness about the influence of early life experiences on the development of cardiovascular disease and to study how pregnancy complications may influence the cardiovascular risk trajectory of women. It will enable me to investigate the impact of premature birth on cardiovascular risk in adulthood for both mothers and their offspring and to review our national guidelines for the prevention of cardiovascular disease through a lifespan development lens so we can ensure that premature birth does not lead to a premature death." – Dr Sarah Harris

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