Preemies Can Carry Health Risks Into Adulthood

By Anastacia Mott Austin

Most parents of premature babies are intensely focused on their infants’ abilities to survive the first few days, weeks, then months of life. It is another world, of breathing tubes, incubators and heart monitors, hope and fear.

A new study released this week reveals that those anxieties may need to extend a bit later, sometimes even into adulthood.

Researchers from Duke University Medical Center studied Norway’s extensive birth registry to develop the world’s largest ever long-term study of premature birth.

The report, released in this week’s issue of Journal of the American Medical Association, followed the health of over one million people born between 1967 and 1988, both full term and pre-term.

What they found was that prematurity seemed to be an indicator for certain future health problems, including infertility and early death.

While the study’s authors did point out that the majority of premature infants go on to live healthy, normal lives, when studied as a group their prematurity did predispose them to some health challenges.

While most people are aware that premature infants face a higher risk of serious illness, health complications, and death during the first year after birth, the researchers were surprised to find that the risk seemed to carry on longer than the first year of life.

The overall risk of death in childhood was higher for those born prematurely, and the risk continued until age six for girls and up to age 13 for boys. Those born the earliest – from gestational weeks 22 to 27 – had the highest risk.

Said researcher Dr. Geeta K. Swamy, to reporters, "Pre-term birth is a major cause of infant mortality, so you would expect to find more deaths in the first year of life or even the first couple of years. But we were surprised to find that the increased risk persisted into childhood and even into adolescence in boys."

In addition, those born very early were less likely to reproduce. In 2004, 68% of women and 50% of men born full-term had had children. But only 25% of extremely pre-term women and 14% of men had reproduced. The higher the gestational age at birth, the better the adult reproduction rate was, leading the study’s authors to draw a correlation between the two.

The study did not examine the specific reasons for the higher death risk and lower fertility rates among adults of premature birth. One theory is that premature babies’ organs do not have sufficient time to develop in the womb and therefore are susceptible to damage or illness. Sociological factors were also not looked at, such as whether those born extremely prematurely may have physical or social disabilities that might prevent or delay them from marrying.

There is hope, say neonatal experts. The study only examined people born before 1988, before many technological advances made survival and quality of life better for preemies.

"These outcomes are all from babies who didn't benefit from the most modern respirators, the most modern technology, the most modern treatments," said Dr. Alan Fleischman, medical director for the March of Dimes, to the press.

It is not known whether babies born prematurely today would face the same issues of those in the study.

While it is important to remember that the majority of premature babies in the study suffered no long-term health effects, experts say that the circumstances of one’s birth should not be ignored. Said Dr. David Adamkin, a representative for the American Academy of Pediatrics, to reporters, "[This study] reminds us that prematurity is a very significant health problem that lasts a lifetime."