How does premature birth affect long-term health?

Research from Auckland’s Liggins Institute found that adults born prematurely had no statistically significant differences in diabetes, prediabetes or dyslipidemia and had fewer cardiovascular events than adults born full-term. A higher probability of developing high blood pressure at the age of 50 was observed among the premature group.

Preterm birth occurs before 37 weeks of gestation and affects approximately one in 10 births worldwide. Outcomes in adulthood have previously been associated with an elevated risk of cardiovascular disorders, including hypertension and stroke. These earlier surveys rarely included people in their 40s in the modern era of improved neonatal care.

The long-term consequences for those born prematurely are therefore not subject to contemporary research evaluation to identify potential age-related health risks.

In the study, “Health Outcomes 50 Years After Preterm Birth Among Participants in a Prenatal Betamethasone Trial,” published In PediatricsResearchers followed up people initially enrolled in a double-blind, placebo-controlled trial of antenatal betamethasone at the National Women’s Hospital in Auckland.

Participants completed a health questionnaire and provided consent to review administrative health data. Clinical endpoints measured included hypertension, diabetes mellitusprediabetes, treated dyslipidemia and major adverse cardiovascular events. Secondary outcomes covered respiratory problems, mental healthadditional educational and health measures.

More than a third of adults born prematurely had higher rates of high blood pressure (34.7% vs. 19.8%), but the overall risk of major adverse cardiovascular events was lower in this group than in full-term peers (2.8% vs. 6.9%).

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

Mental health disorders were less common among preterm participants (38.2% vs. 52.9%). Self-reported depression was less common in the premature group. Educational attainment and mortality after the first year of life do not vary significantly.

The results suggest that worse cardiovascular outcomes are not universal for all people born prematurely, particularly those born with moderate gestation. These results provide nuanced insight into the long-term impacts of premature birth in the era of prenatal corticosteroid use.

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