Risk Factors in the First 1000 Days of Life and Carotid Intima-Media Thickness in Children: A Systematic Review and Meta-Analysis - EAP 2019 Congress and MasterCourse Porto Palacio Hotel

Adina Mihaela Epure ¹ Magali Leyvraz ¹ Daniela Anker ² Yvan Mivelaz ³ Stefano Di Bernardo ³ Bruno R da Costa ^2,5 Arnaud Chiolero ^1,2,4 Nicole Sekarski ³

¹Department of Epidemiology and Health Services, Center for Primary Care and Public Health (UNISANTÉ), University of Lausanne, Switzerland
²Institute of Primary Health Care (BIHAM), University of Bern, Switzerland
³Pediatric Cardiology Unit, Woman-Mother-Child Department, Lausanne University Hospital (CHUV), Switzerland
⁴Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Canada
⁵Institute of Health Policy, Management and Evaluation, University of Toronto, Canada

Background: The first 1000 days of life, i.e. from conception to age 2 years, could be a critical period in the development of cardiovascular disease (CVD) risk. Carotid-intima media thickness (CIMT) is a surrogate marker of CVD. Although early-life risk factors, such as low birth weight or premature birth, are associated with increased CIMT in adults, it is unclear whether the relationship is present at younger ages.

Objective: Our objective was to assess the relationship between exposures or interventions in the first 1000 days of life and CIMT in children through a systematic review and meta-analysis.

Methods: Systematic searches of MEDLINE, EMBASE and CENTRAL databases were performed. Experimental and observational studies investigating the association between ultrasound CIMT and exposures or interventions at the child, familial, or environmental level, which occurred in the first 1000 days of life, were included. Data will be synthesized descriptively and, when appropriate, random-effects meta-analyses will be conducted. Funding: SNSF 32003B-163240.

Results: A total of 5,561 publications were screened and 38 full-text publications, from 26 observational and 2 experimental studies, were retained. Observational studies comprised a total of 5,610 participants (0 to 18 years) and reported a wide range of exposures, from abnormal fetal growth to maternal dysglycemia or air pollution. Experimental studies comprised a total of 788 participants (5 to 8 years) and focused on nutritional interventions. Most of the studies were conducted in high-income countries, with 18 in Europe and only 2 in North America. Data analysis is ongoing and further results will be available by September 2019.

Conclusion: Preliminary results indicate that the relationship between multiple early-life exposures or interventions and CIMT was evaluated across various populations and in different pediatric age groups. This systematic review will improve the knowledge on the mechanisms underpinning the developmental origins of CVD.