Low- and high-birthweight babies at increased heart disease risk

Both birthweight extremes appear to increase the likelihood of early development of dangerous fat around major organs in the abdomen.

Washington D.C.:

If your baby has either a low birthweight or a high one, she/he may be at an increased risk for cardiovascular disease, according to a recent study.

For reasons that remain unclear at least in the smaller babies, both birthweight extremes appear to increase the likelihood of early development of dangerous fat around major organs in the abdomen that significantly increases these risks, said neonatologist Dr. Brian Stansfield of Georgia at Augusta University.

By adolescence, the children have not just more of this visceral adiposity, a stand-alone risk factor for cardiovascular disease, but more related problems such as insulin resistance and inflammation than their average birthweight peers, according to a study of 575 adolescents, now age 14-18, divided into three groups by birthweight.

The findings were independent of other usual cardiovascular risk factors such as lower activity levels and socioeconomic status as well as higher body mass index - weight divided by height - which actually did not vary much among all three birthweight groups, according to the study in the Journal of Pediatrics.

And while the association between low birthweight and future cardiovascular disease is well-recognized, the new study showed the association may not be easily modified by healthy eating and exercise, Stansfield said.

Rather, researchers found adolescents born low birthweight had a similar body build as adolescents born at average birthweight but still had greater visceral adiposity and high insulin levels in their blood. Both are usually associated with generalized obesity and an elevated BMI.

"The 5-pound baby, regardless of whether he grows up to be obese, normal weight or thin is going to have more visceral adiposity than a similar child with a normal birthweight," said Stansfield, corresponding author. A heavy baby, on the other hand, who exercises and eats healthy as he grows, may reduce his risk.

The take-home message for mothers-to-be also is not new, Stansfield said: Don't smoke and do breastfeed. Maternal smoking is the number one cause of low-birthweight babies, and breast milk may be protective. The take-home message for his fellow physicians is: When assessing cardiovascular risk in adult patients, consider birthweight a factor.

The study appears in Journal of Pediatrics.