Physical fitness in adolescents born preterm or small for gestational age in rural Malawi
1
Clinical Medicine Research Unit, University of Oulu, Oulu, Finland
2
Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
3
School of Global and Public Health, Kamuzu University of Health Sciences, Blantyre, Malawi
4
Center for Child, Adolescent and Maternal Health Research, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
5
Department of Paediatrics, Tampere University Hospital, Tampere, Finland
6
Public Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
Popul. Med. 2026;8(Supplement Supplement 1):A2279
ABSTRACT
INTRODUCTION:
Preterm (<37 weeks of gestation) and small for gestational age (SGA, <10th percentile) infants face higher mortality and greater risk of later cardiometabolic disorders than those born at term1. Muscle strength and cardiorespiratory fitness are key components of physical fitness and strong predictors of long term health, linked to lower all-cause mortality2,3. However, previous evidence on physical fitness after being born preterm or SGA largely comes from high-resource settings4.
METHODS:
Lungwena Antenatal Intervention Study (LAIS), enrolled 1320 women to examine effects of maternal antimalarial treatment during pregnancy5. Gestational age was confirmed by ultrasound, and the children have subsequently been followed up. At 17 years of age, 818 LAIS adolescents were examined: 94 (11.0%) were born preterm appropriate for gestational age (AGA), 12 (1.4%) preterm SGA, 130 (15.2%) term SGA, and 582 (67.8%) were born term AGA, which served as a comparison group. Muscular fitness was assessed using maximum handgrip strength and number of push-ups performed in 30 seconds. Heart rate at the end of a 4-minute step test was used to measure cardiorespiratory fitness.
RESULTS:
Among the comparison group, mean(SD) dominant-hand grip strength was 29.1 (6.3) kg and 26.1 (4.8) kg for boys and girls, respectively. Girls performed fewer push-ups than boys. In a pooled analysis adjusted for sex and age, handgrip strength was 1.2 (95% CI 0.1-2.4) kg lower in preterm AGA group, 3.9 (0.9-6.8) kg lower in the preterm SGA group and 2.4 (1.4-3.4) kg lower in the term SGA group compared with term AGA group. No group differences were observed in number of push-ups or heart rate after step test.
CONCLUSIONS:
Adolescents born preterm or SGA in a rural, low-resource setting had lower handgrip strength than their peers born AGA at term. Physical activity should be encouraged in childhood to build muscle strength and fitness.
Preterm (<37 weeks of gestation) and small for gestational age (SGA, <10th percentile) infants face higher mortality and greater risk of later cardiometabolic disorders than those born at term1. Muscle strength and cardiorespiratory fitness are key components of physical fitness and strong predictors of long term health, linked to lower all-cause mortality2,3. However, previous evidence on physical fitness after being born preterm or SGA largely comes from high-resource settings4.
METHODS:
Lungwena Antenatal Intervention Study (LAIS), enrolled 1320 women to examine effects of maternal antimalarial treatment during pregnancy5. Gestational age was confirmed by ultrasound, and the children have subsequently been followed up. At 17 years of age, 818 LAIS adolescents were examined: 94 (11.0%) were born preterm appropriate for gestational age (AGA), 12 (1.4%) preterm SGA, 130 (15.2%) term SGA, and 582 (67.8%) were born term AGA, which served as a comparison group. Muscular fitness was assessed using maximum handgrip strength and number of push-ups performed in 30 seconds. Heart rate at the end of a 4-minute step test was used to measure cardiorespiratory fitness.
RESULTS:
Among the comparison group, mean(SD) dominant-hand grip strength was 29.1 (6.3) kg and 26.1 (4.8) kg for boys and girls, respectively. Girls performed fewer push-ups than boys. In a pooled analysis adjusted for sex and age, handgrip strength was 1.2 (95% CI 0.1-2.4) kg lower in preterm AGA group, 3.9 (0.9-6.8) kg lower in the preterm SGA group and 2.4 (1.4-3.4) kg lower in the term SGA group compared with term AGA group. No group differences were observed in number of push-ups or heart rate after step test.
CONCLUSIONS:
Adolescents born preterm or SGA in a rural, low-resource setting had lower handgrip strength than their peers born AGA at term. Physical activity should be encouraged in childhood to build muscle strength and fitness.
| eISSN: | 2654-1459 |
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