Preterm infants have increased risk of psychological and physical health comorbidities at adulthood

1. U.S. adults born preterm have increased internalizing mental health problems, blood pressure, triglycerides, and body fat distribution, along with lower high-density lipoprotein cholesterol and bone density at age 35 compared with their full-term peers.

Evidence Rating Level: 2 (Good)

Preterm birth can have lifelong consequences, with research showing that adults born preterm face a higher risk of various chronic conditions, including diabetes, heart failure, and ischemic heart disease. Given that much of the current research on individuals born preterm comes from international studies of homogeneous populations, there is a need to study health outcomes in a more diverse, U.S.-born cohort. This study thus aimed to examine how early-life medical risk from preterm birth is associated with psychological and physiological health in adulthood. This study analyzed data from the Rhode Island Cohort of Adults Born Preterm (RHODE) Study cohort, the longest continuously running US study of individuals born preterm, using data from the tenth follow-up conducted between March 2020 and March 2024. This prospective cohort included preterm infants recruited from a Level III neonatal intensive care unit (NICU) in New England between 1985 and 1989, along with a control group of healthy full-term infants. Cumulative medical risk was indexed across multiple follow-up assessments. In total, 158 preterm and 55 full-term–born adults (mean [SD] age = 35.0 [1.3] years, female [%] = 107 [50.2];17 Black [8.0%], 9 Hispanic [4.2%], 186 White [87.3%]) were included in the analysis. Higher birth-childhood medical risk severity was associated with increased adulthood internalizing problems (β [standard error (SE)], 0.85 [0.33]; P = .01), higher systolic blood pressure (β [SE], 7.15 [2.47]; P = .004), lower high-density lipoprotein (good) cholesterol (β [SE], −13.07 [4.4]; P = .003), higher triglycerides (β [SE], 53.97 [24.6]; P = .03), higher android-to-gynoid fat ratio, indicating more central fat accumulation (β [SE], 0.22 [0.08]; P = .006), and lower bone density (β [SE], −1.14 [0.40]; P = .004). Overall, this study found that US adults born preterm with higher early life medical risk had increased mental health disorders, cardiometabolic issues, and body composition differences at age 35 compared with their full-term peers. Evidence-based clinical screening guidelines may be needed for adults born preterm to support early intervention and preventative care.

Click to read the study in JAMA Network Open

Image: PD

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