THE LONG AND SHORT OF IT: Determining the Role of Telomere Length in Preterm Birth and its Associated Adverse Outcomes in Infants, Children and Mothers

Abstract

An emerging body of evidence suggests adverse intrauterine conditions may play a critical role in later life disease susceptibility and health outcomes, particularly among preterm infants. Adult telomere length, a promising potential biomarker of cellular aging, has been associated with many adverse outcomes associated with prematurity. Yet, it is unknown whether this relationship exists in the prenatal period, infancy, and early childhood. We suggest that telomere length may be an important link to the biological mechanisms underlying the association between preterm birth and early aging and early onset of age-related diseases. We sought to determine whether preterm birth, its associated risk factors and outcomes were correlated with telomere length in infants, children and mothers. We used data from two cohorts: (i) 77 newborns from an Edinburgh study (ES), representing term and very preterm birth and (ii) 384 white mother-child pairs from the Fragile Families and Child Wellbeing Study (FFCWS), encompassing preterm and low birth weight births, and diagnoses of preeclampsia, pregnancy-associated hypertension, and gestational diabetes. Natural log transformation was applied to absolute telomere length, measured from buccal cells (ES) or saliva (FFCWS) by real-time quantitative polymerase chain reaction. Although term infants had shorter TL at birth and age one, preterm infants had a more severe rate of attrition during the first year of life in ES. TL at age one and telomere attrition is highly correlated with TL at birth in ES. By age 9, there is no difference in child TL between term and preterm children in FFCWS. Maternal TL was associated with cesarean section, cardiac issues, and child diagnosis of cardiac issues at birth. Child TL was significantly correlated with maternal TL, paternal age at birth, preeclampsia and multiple social outcomes measures. Our finding provides some of the first preliminary evidence that very preterm birth has a consistent rate of accelerated attrition in the first year of life, but not in the womb, as reflected by the setting of newborn TL. Further, it is unlikely for TL to be a useful diagnostic marker of risk factors of preterm birth among mothers or of adverse pregnancy outcomes among children.