Maintaining an active lifestyle from adolescence to adulthood might alleviate the adverse association of preterm birth with cardiometabolic health

Aims: We aimed to determine whether physical activity attenuates preterm birth's adverse effects on adult cardiometabolic health. Methods: This retrospective study utilized data from the Add Health Study, a prospective cohort conducted in the United States. During Wave V (mean age: 37 years; 60.7% women; mean body mass index: 29 kg/m²; mean waist circumference: 95 cm), we evaluated cardiometabolic risk factors and preterm birth status (i.e., born <37 weeks). Self-reported physical activity data was collected through questionnaires during Waves I (ages 12–19) and Wave V. An “active lifestyle” was defined by adherence to recommendations during both waves, spanning from adolescence to adulthood. Results: The sample, comprising 3320 individuals, with 9.5% being preterm, included 7.6% who remained physically active throughout both adolescence and adulthood. Preterm-born individuals who were inactive had higher rates of obesity (incidence rate ratio [IRR] = 1.39, 95% confidence interval (CI) 1.05–1.84), abdominal obesity (IRR = 1.46, 95% CI 1.11–1.92), hyperlipidemia (IRR 3.50, 95% CI 1.94–4.29), type 2 diabetes (IRR = 2.37, 95% CI 1.12–5.01), and metabolic syndrome (IRR = 2.61, 95% CI 1.17–5.80) compared to active term-born individuals. Maintaining an active lifestyle appeared to decrease the risk of obesity and hyperlipidemia in adults born preterm (p > 0.05). Conclusions: While preterm birth is associated with an elevated risk of adult cardiometabolic risk, maintaining an active lifestyle appeared to slightly mitigate the risk of obesity and hyperlipidemia in adults born preterm.