Background

Preterm birth and low birthweight (LBW) might be associated with reduced physical fitness, although evidence remains inconclusive.

Objective

To examine the influence of preterm birth and LBW on physical fitness, as well as to assess whether variables such as gestational age, birthweight, or age at assessment moderate these effects.

Methods

PubMed, Scopus, and PsycINFO were systematically searched from inception to 7 December 2023 for case–control and cohort studies analyzing the association between preterm birth or LBW (or gestational age or birthweight as continuous variables) with at least one physical fitness-related outcome (i.e., cardiorespiratory fitness (CRF), muscle strength, flexibility, speed, agility). Random-effects meta-analysis and meta-regression models were used to estimate the pooled effect size, as well as to examine potential associations between the magnitude of the effect and gestational age, birthweight, or age at assessment.

Results

Fifty-two studies (n = 920,603 participants, average age ranging from 4.7 to 34.4 years) were included. Preterm birth was associated with reduced CRF (standardized mean difference (SMD) = −0.38, 95% confidence interval (CI) = −0.51 to −0.25) and muscle strength (SMD = −0.44, 95% CI = −0.79 to −0.08). LBW was associated with reduced CRF (SMD = −0.40, 95% CI = −0.64 to −0.17), muscle strength (SMD = −0.18, 95% CI = −0.24 to −0.13), flexibility (SMD = −0.11, 95% CI = −0.22 to −0.01), and agility (SMD = −0.99, 95% CI = −1.91 to −0.07). Meta-regression analyses showed that a lower gestational age or birthweight were associated with larger reductions in physical fitness, whereas no consistent association was found for the age at assessment.

Conclusion

Both preterm birth and LBW seem associated with reduced physical fitness regardless of age, with larger reductions overall observed in individuals with lower gestational age or birthweight. These findings might support the implementation of preventive strategies (e.g., fitness monitoring and physical exercise interventions) in these populations through the life course.

PROSPERO registration: CRD42021231845.

Graphical Abstract

中文翻译：

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早产和低出生体重对身体健康的影响：系统回顾、荟萃分析和荟萃回归

背景

尽管证据尚无定论，但早产和低出生体重（LBW）可能与身体健康状况下降有关。

客观的

研究早产和低出生体重对身体健康的影响，并评估胎龄、出生体重或评估年龄等变量是否会减轻这些影响。

方法

从开始到 2023 年 12 月 7 日，系统地检索了 PubMed、Scopus 和 PsycINFO 的病例对照和队列研究，分析早产或低出生体重（或孕龄或出生体重作为连续变量）与至少一项身体健康相关结果之间的关联（即心肺健康（CRF）、肌肉力量、灵活性、速度、敏捷性）。随机效应荟萃分析和荟萃回归模型用于估计汇总效应大小，并检查效应大小与胎龄、出生体重或评估年龄之间的潜在关联。

结果

纳入52 项研究（n  = 920,603 名参与者，平均年龄从 4.7 岁到 34.4 岁不等）。早产与 CRF 降低（标准化平均差 (SMD) = -0.38，95% 置信区间 (CI) = -0.51 至 -0.25）和肌肉力量降低（SMD = -0.44，95% CI = -0.79 至 -0.08）相关）。 LBW 与 CRF 降低（SMD = -0.40，95% CI = -0.64 至 -0.17）、肌肉力量（SMD = -0.18，95% CI = -0.24 至 -0.13）、灵活性（SMD = -0.11，95）相关。 % CI = -0.22 至 -0.01）和敏捷性（SMD = -0.99，95% CI = -1.91 至 -0.07）。荟萃回归分析表明，较低的胎龄或出生体重与身体健康状况的较大下降相关，但与评估时的年龄没有发现一致的关联。

结论

无论年龄大小，早产和低出生体重似乎都与体能下降有关，胎龄或出生体重较低的个体总体下降幅度更大。这些发现可能支持在这些人群的整个生命过程中实施预防策略（例如，健康监测和体育锻炼干预措施）。

PROSPERO 注册号：CRD42021231845。

图形概要