How does being born prematurely affect long-term health?

Research led by the Liggins Institute in Auckland found that adults born prematurely had no statistically significant differences in diabetes, prediabetes or dyslipidemia and had fewer cardiovascular events compared to full-term adults. The premature group was found to have a greater risk of developing high blood pressure at the age of 50.

Preterm birth occurs before 37 weeks’ gestation and affects an estimated one in ten births worldwide. Outcomes in adulthood have previously been associated with an increased risk of cardiovascular disease, including hypertension and stroke. These previous studies rarely included individuals who reached middle age in the modern era of improved neonatal care.

Long-term consequences for those born prematurely are therefore lacking in a contemporary research review to identify potential age-related health risks.

In the study ‘Health outcomes 50 years after preterm birth in participants in a trial of prenatal betamethasone’ published in Pediatricsresearchers conducted a follow-up of individuals who originally participated in a double-blind, placebo-controlled trial of prenatal betamethasone at the National Women’s Hospital in Auckland.

Participants completed a health questionnaire and consented to administrative review of health data. The clinical endpoints measured included hypertension, diabetes mellitus, prediabetes, treated dyslipidemia and major cardiovascular events. Secondary outcomes covered respiratory, mental health, education and additional health metrics.

More than a third of preterm adults had higher reported rates of hypertension (34.7% vs. 19.8%), yet the overall risk of major cardiovascular events was lower in this group than in full-term peers (2 .8%). versus 6.9%).

The rates of diabetes, prediabetes, and treated dyslipidemia were not significantly different. Respiratory outcomes were generally similar and no significant differences were observed in the prevalence of chronic kidney disease.

Mental disorders were less common in preterm participants (38.2% vs. 52.9%). Self-reported depression was less common in the preterm group. Education level and mortality after the first year of life did not vary significantly.

The results suggest that worsened cardiovascular outcomes are not universal for all individuals born preterm, especially for those born with moderate gestation. These findings provide nuanced insights into the long-term effects of preterm birth in the era of prenatal corticosteroid use.

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