Early-term babies may be more likely to have diabetes, be obese as they grow older

Babies delivered early term, between 37 and 39 weeks, are at higher risk for shorter life spans, diabetes and obesity-related illnesses, according to research recently published in the American Journal of Obstetrics and Gynecology.

“As endocrine and metabolic morbidity is more common in preterm born children, we sought to determine whether early-term deliveries impact on the long-term pediatric endocrine and metabolic health of the offspring,” Dorit Paz Levy, MD, of the department of obstetrics and gynecology, Soroka University Medical Center, Beer-Sheva Israel, and colleagues wrote.

To see if there was a connection, researchers conducted a population-based cohort analysis on 225,260 all term singleton deliveries occurring during 1991 to 2013 at a single medical center in Israel. Of these, 54,073 were early term. Metabolic and endocrine morbidity such as hypoglycemia, hyperlipidemia, hypothyroidism, diabetes and obesity in these children were recorded up until the age of 18. Kaplan-Meier survival curves were utilized to analyze total morbidity incidence, and a Weibull parametric survival model was used to control for confounders.

Researchers found that metabolic and endocrine morbidity occurred more frequently in the early-term group than those born at full term (0.51% vs. 0.41%, P = .003). In addition, obesity and overweight were more common among the early-term group (P = .002). Children older than 5 years who were delivered early term showed higher rates of type 1 diabetes mellitus, as well as obesity (P < .05).

In addition, Paz Levy and colleagues found that the survival curves showed higher cumulative incidence of total endocrine and metabolic morbidity in the early-term group. The Weibull model, controlling for labor induction, hypertension, maternal diabetes and siblings, as well as Apgar score, showed that early-term delivery exhibited an independent relationship with long-term childhood endocrine and metabolic morbidity of the offspring (adjusted HR = 1.17; 95% CI, 1.01-1.34) especially after the child turned 5 years old (adjusted HR = 1.3; 95% CI, 1.08-1.56).

Researchers also found that there was a 30% increase in morbidity at ages 5 through 18 years among early-term births, and only a 17% increase at ages 0 through 18 years among the full-term births.

“This association may be due to absence of full maturity of the hormonal axis in early-term neonates or, alternatively, suggesting an underlying fetal endocrine dysfunction as the initial mechanism responsible for spontaneous early term delivery,” Paz Levy and colleagues wrote.

The authors encouraged further research to confirm their findings and propose further causative pathways. - by Janel Miller

Disclosure: The researchers report no relevant financial disclosures.