Prematurity and programming: are there later metabolic sequelae?

Low birth weight has a well-established association with early-onset insulin resistance and a later risk of adult diseases, including all aspects of the metabolic syndrome. Although most studies to date have focused on term low-birth-weight subjects, other low-birth-weight groups (such as prematurely born children) need evaluating. In this review, we demonstrate that prematurely born children have a metabolic profile very similar to term small-forgestational- age (SGA) children and may have a similar increased risk of the metabolic syndrome later in life. We propose mechanisms (in particular, epigenetic alterations and the higher risk of hypomethylation in prematurely born children) by which this could occur.