1Pediatric Department Hospital Italiano de Buenos Aires, Argentina
2Pediatric Nephrology Service, Universidad de Buenos Aires, Argentina
*Corresponding author: Maria Agostina Grillo and Jorge R Ferraris, Pediatric Department Hospital Italiano de Buenos Aires, Pediatric Nephrology Service, Universidad de Buenos Aires, Argentina
Submission: May 20, 2024;Published: June 10, 2024
ISSN : 2576-9200Volume8 Issue3
Preterm newborns and small for gestational age (SGA) are particularly vulnerable to the development of hypertension (HTN) and chronic kidney disease (CKD). Fetal programming of HTN occurs in response to an insult during intrauterine life, which leads to adaptations by the fetus to allow fetal survival, but also results in permanent structural and physiological changes with long-term consequences such as an increased risk for cardiovascular disease and HTN. The mechanisms involved are: Renal alterations, vascular dysfunction, oxidative stress and epigenetic changes. Diagnosis and treatment of neonatal HTN remain challenging, with global incidence from 0.2%-3%, and there are a multitude of causes of neonatal hypertension. Most prematurity-related neonatal HTN resolves but the compensation mechanisms responsible may leave them at risk of later cardiovascular and kidney disease, in later childhood or adulthood, with a prevalence of HTN in children/adolescents born preterm up to 25%, diagnosed with both health check and ambulatory blood pressure monitoring. In adulthood gestational age is inversely associated with ischemic heart disease risk. They could present altered cardiac shape characterized by increased right and left ventricular mass, reduced right and left ventricle lengths, and smaller internal cavity diameters. Up to 10% of the population are preterm individuals, so we are facing a “silent epidemic” of CKD and HTN in these patients; preventive strategies should be implemented early to avoid the progression of these and CVD.
Keywords: Preterm neonates; Low birth weight; Arterial hypertension; Fetal programming; Small for gestational age; Cardiovascular disease