Most people born prematurely do not have major health issues in adulthood

Nearly 55% of those born prematurely survive through early or mid-adulthood without a major comorbidity, according to data from a national cohort study published in JAMA.

“The findings reflect the apparent resilience of preterm birth survivors in maintaining good health,” Casey Crump, MD, PhD, vice chair for research of the Alfred and Gail Engelberg Department of Family Medicine and Community Health in the Icahn School of Medicine at Mount Sinai, told Healio Primary Care. “Despite increased risks of several chronic disorders, the majority can still have good overall health in adulthood.”

Previous studies — most focusing on specific adverse outcomes — found that preterm birth was associated with higher long-term risks for multiple major comorbidities and had slightly higher mortality rates in early to mid-adulthood, Crump explained.

Researchers conducted a national cohort study that included more than 2.5 million people born in Sweden between 1973 and 1997 with data available through 2015. They compared the prevalence of comorbidities — including asthma, hypertension, diabetes, mental disorders, kidney disease and epilepsy — in those born full-term and those born prematurely.

 

Nearly 55% of those born prematurely survive through early or mid-adulthood without a major comorbidity, according to data from a national cohort study published in JAMA.

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The median age at the end the follow-up period was 29.8 years.

They found that after follow-up, 54.6% of those born preterm were alive without a major comorbidity.

After stratifying for gestational age, researchers found that the prevalence was significantly lower in those born extremely preterm (22 to 27 weeks), with just 22.3% surviving to early or mid-adulthood without a major comorbidity. The prevalence increased with gestational age, to 48.5% for those born very preterm (28 to 33 weeks), 58% for late preterm (28 to 33 weeks) and 61.2% for early term birth (34 to 36 weeks).

In comparison, 63% of those born full-term lived to adulthood without a major comorbidity.

The findings were similar in men and women and were independent of other factors, including birth year and fetal growth.

“Because of improved early treatment of preterm birth, clinicians will increasingly encounter adult patients who were born prematurely and will need to understand their long-term health risks,” Crump said. “Our findings can help inform counseling of preterm-born patients and their families.

As preterm birth is tied to slightly increased risks for chronic conditions in adulthood, “persons born prematurely can support their long-term health by committing to a healthy lifestyle across the life course, including physical activity, a healthy diet, maintaining a normal weight, and avoidance of smoking or other substance use,” she continued.

Crump noted that those born prematurely should also receive follow-up for preventive care as children, adolescents and adults. – by Erin Michael

Disclosures: Crump reports no relevant financial disclosures. Please see study for all other authors’ relevant financial disclosures.