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Adverse Birth Outcomes and Birth Telomere Length: A Systematic Review and Meta-analysis

Fetal growth restriction (FGR) and preterm birth are associated with an increase in morbidity and mortality during infancy. Growth-restricted and preterm newborns are also at an increased risk of developing obesity, hypertension, non–insulin-dependent diabetes, and atherosclerosis later in life. Telomere length is associated with cellular aging and has also been associated with adverse perinatal outcomes. The goal of this study was to perform a systematic review and meta-analysis to research telomere length in newborns with FGR and preterm birth. A systematic review was performed using PubMed, EMBASE, and Web of Science and included 15 articles on the relationship between telomere length and FGR/preterm birth. Articles included were published in academic journals, were full text in English, had an abstract, and reported on studies that involved humans with singleton births. The authors conducted a meta-analysis to gather the information on the difference in birth telomere length with FGR and non-FGR newborns. They also collected information on the difference in birth telomere length with preterm and full-term babies. Subgroup analyses were also performed, in which articles were classified by the type of tissue used in telomere length measurement, as well as the technique used for telomere length measurement. Overall, FGR correlated with shorter birth telomere length when the length was measured in placenta (pooled standardized mean difference [SMD], −0.85; 95% confidence interval [CI], −1.13 to −0.57; FGR/non-FGR n = 87/173). Furthermore, birth telomere length was notably longer in preterm birth than in full-term birth when length was measured by quantitative polymerase chain reaction (qPCR) (pooled SMD, 0.40; 95% CI, 0.18–0.63; preterm birth/full-term birth n = 137/682). Future research should focus on the effects of FGR and preterm birth on childhood telomere length.