This article is more than 5 years old. Information may no longer be current.
Preemies face unemployment, other challenges in adulthood
Click Here to Manage Email Alerts
Children with preterm birth and low birth weight have lower rates of education and employment and a higher rate of receiving social benefits in adulthood, according to recently published research in Pediatrics.
“[We] evaluated 23 studies of preterm children (< 37 weeks’ gestation) and term born children born in North America, Europe and Australasia who had been followed into adulthood,” Dieter Wolke, PhD, Dr. rer. nat. h.c. Dipl-Psych, professor in the department of psychology and member of the Lifespan Health and Wellbeing Group at the University of Warwick Medical School in Coventry, United Kingdom, told Infectious Diseases in Children.
“Very preterm children (< 32 weeks’ gestation) have been previously found to have, on average, lower cognitive abilities and poorer school achievement,” Wolke continued. “The findings indicate that they obtain poorer educational qualifications in adulthood, are more likely to have periods of unemployment and more likely to draw social benefits compared to those born at term.”
Wolke and colleagues noted that 11.1% of children are born preterm worldwide, including 8.6% of those children born in developed countries.
To measure whether preterm birth and low birth weight (PT/LBW) are associated with decreased wealth in adulthood, the researchers conducted a literature search of Medline, PubMed, PsycINFO, Web of Science and Embase for longitudinal and registry studies of wealth markers in adults who were born PT or LBW (< 2,500 g at birth) that were published from January 1980 to May 2017.
Two independent reviewers screened 1,347 articles, they said.
To be included in the analysis, studies had to have a term healthy control group and participants aged at least 18 years at the time of outcome assessment.
Twenty-three studies were examined in the meta-analysis, which included 271,767 participants born PT/LBW and 5,645,334 born at term. Birth weight was reported in seven studies, gestational age was reported in 15 studies, and birth weight and gestational age were included in one study.
Seventeen studies from were from Europe, four from North America and two from Australasia.
Children with PT/LBW had a mean birth weight of 1,618.5 g (SD = 717.4) compared with 3,494.9 g (SD = 189.9) for term children. The PT/LBW children had a mean gestational age of 30.4 weeks (SD = 2.8 weeks) compared with 39.6 weeks (SD = 1.1 weeks) for full-term children. At assessment, the participants ranged in age from 18 to 66 years.
Decreased likelihood of attaining higher education (OR = 0.74; 95% CI, 0.69-0.80) and lower employment rate (OR = 0.83; 95% CI, 0.74-0.92) were both associated with PT/LBW. The participants in the cohort also were more likely to receive social benefits (OR = 1.25; 95% CI, 1.909-1.42).
Regarding independent living, there was not a significant difference between PT/LBW adults and term comparison adults (combined mean OR = 0.78; 95% CI, 0.6-1.01). Cohort studies in the analysis reported that PT/LBW children were less likely to live independently (OR = 0.59; 95% CI, 0.44-0.79), whereas registry studies reported that the cohort was more likely to live independently (OR = 1.09; 95% C I, 1.01-1.18).
Wolke reported that it was “somewhat surprising that those born moderate to late preterm (32-36 weeks’ gestation) had poorer educational qualifications and periods of unemployment and were more likely to draw social benefits than term born participants” when compared with those born very preterm. He added that most adults born very preterm are employed and do not require social benefits.
Wolke also said that there was a lack of long-term studies of preterm children into adulthood in the United States, “despite the U.S. having the highest preterm birth rate of industrialized countries.”
“Future research should identify what are the protective and resiliency factors so that appropriate support and interventions can be developed,” he concluded. – by Bruce Thiel
Disclosures: The authors report no relevant financial disclosures.
Collapse
Click Here to Manage Email Alerts