Prevention of arterial hypertension and cardiovascular disease in premature infants later in life by examining early kidney development.

Heart research Australia and the Mill House Foundation have been supporting newborn cardiac research projects in the department of Neonatology at Royal North Shore Hospital for over 23 years. The generous donations by the Mill House Foundation via Heart Research Australia fund the position of a part time research nurse for the past 17 years in the Department of Neonatology at Royal North Shore Hospital. The current research nurse, Ms Yan Chen, is invaluable for the gathering of data and general smooth running of the study. For this support, the research team is deeply grateful. 

Dr Staub and Professor Kluckow are investigating hypertension and problems associated with blood vessels in babies currently being born pre-term, to try to understand what is causing these teens and young adults born prematurely to suffer these cardiac risk factors at such a younger age than those born at term. This study collaborates with several other hospitals around Australia to develop and conduct new clinical studies in their quest to understand the problems with heart function in premature and sick infants.  

Each year 26,000 babies are born prematurely in Australia. Even those born just a few weeks before their due date have a higher risk of suffering and dying from cardiovascular disease as adults. Professor Kluckow’s world-first study applies new ultrasound technology to observe the growth of small blood vessels in the kidneys of preterm babies from birth to childhood. This will offer insight into the mechanisms that lead preterm babies to develop high blood pressure and poorer health because the kidneys are vitally important to regulate blood pressure. Eventually, this study will not only help raise awareness that prematurely born individuals need lifelong blood pressure and heart health monitoring, but hopefully help prevent these late adverse outcomes. 

The pilot study has successfully established that the new ultrasound technique is safe and feasible for vulnerable newborn babies. The preliminary results confirm the validity of the project aim of investigating the development of small blood vessels in the outer layer of the kidney. The careful setting up of the study encourages parents to consent for the first part of the study and follow-up studies in years to come.  

Recent publications report that adults born pre-term have almost double the risk of death from cardiovascular diseases compared to adults born at term. The area of long-term cardiac health in preterm infants is a current hot topic with several lines of investigation assessing cardiac risk in young adults born preterm. This study has the potential to contribute substantially to the understanding how preterm birth leads to poorer heart health: less well grown blood vessels in the outer layer of the kidneys could be the key step to development of high blood pressure and subsequent cardiovascular disease.