Context: Both small-for-gestational-age (SGA) and preterm birth have been associated with increased incidence of adult cardiovascular disease and diabetes mellitus type 2. It is however unclear if preterm birth has an additional effect on cardiovascular risk factors in short children born SGA.

Objective: To investigate if prematurity has an independent influence on several cardiovascular risk factors within a population of short SGA children.

Design: Cross-sectional observational study

Patients: 479 short SGA children (mean age 6.8 years), divided in preterm (< 36 weeks) and term ( 36 weeks) children.

Outcome measure: Insulin sensitivity, beta cell function, body composition and lipid levels were studied in subgroups; blood pressure, anthropometry at birth and during childhood in the total group

Results: Preterm SGA children were significantly lighter and shorter at birth after correction for gestational age than term SGA children (p<0.001), but had a comparable head circumference. In preterm SGA children, we found a significantly higher systolic (p=0.003) and diastolic blood pressure SDS (p=0.026), lower body fat % SDS (p=0.011), and higher insulin secretion (p=0.033) and disposition index (p=0.021), independently of the degree of SGA. Insulin sensitivity, serum lipid levels, muscle mass and body fat distribution were comparable for preterm and term SGA children.

Conclusions: Within a population of short SGA children, preterm birth has divergent effects on several cardiovascular risk factors. Whereas preterm SGA children had a higher systolic and diastolic blood pressure, they also had a lower body fat % and a higher insulin secretion and disposition index than term SGA children.