The effect of preterm birth on adiposity and metabolic pathways and the implications for later life

The last few years have seen an increasing number of extremely preterm babies surviving to adulthood. The relationship between low birth weight, insulin resistance and Type 2 diabetes in adulthood is well established, but less is known regarding the effects of preterm birth on body composition and metabolic pathways. In this review, we consider the literature regarding the effects of prematurity on body composition in the neonatal period, infancy, childhood and adulthood. We also discuss prematurity and metabolic related changes including blood pressure and insulin resistance in later life. Although several studies suggest that 'catch-up' growth is the main factor influencing the risk of an adverse body composition and metabolic profile, there is growing evidence to indicate an independent effect of gestational age on liver fat content and blood pressure in adulthood. However, more research is needed regarding specific metabolic changes in adults born preterm.