Two major studies have revealed the far-reaching consequences of preterm birth, demonstrating that its impacts extend well beyond childhood and into adulthood, affecting both socioeconomic outcomes and mortality risk.
Research published November 6 in PLOS One analyzed data from approximately 2.4 million live births in Canada between 1990 and 1996, finding that adults who were born before 37 weeks gestation face significant disadvantages in education and employment compared to their full-term counterparts.
"Our findings suggest that the development of long-term supports that go beyond clinical care may help mitigate the longer-term effects of preterm birth," said researcher Petros Pechlivanoglou from The Hospital for Sick Children in Toronto.
Educational and Economic Disparities
The study revealed that individuals born preterm are 17% less likely to enroll in college and 16% less likely to complete a college degree. These educational disadvantages translate to economic impacts, with preterm-born adults being 2% less likely to be employed and earning an average of 6% less than those born at full term.
For those born extremely preterm (24-27 weeks gestation), the disparities are even more pronounced. These individuals face a 45% decrease in university enrollment and graduation rates and earn 17% less annually compared to full-term peers.
"Policymakers and society as a whole must recognize that the socioeconomic impact of preterm birth may extend into early adulthood and that considerations for ongoing support could be vital to ensuring this population has equal opportunity to thrive," Pechlivanoglou emphasized.
Mortality Risk Persists Into Adulthood
A separate study published in JAMA Network Open reinforces concerns about the long-term health implications of preterm birth. Researchers from Wake Forest University School of Medicine analyzed nearly 5 million Canadian births between 1983 and 1996, following subjects for 23 to 36 years.
The research team, led by Dr. Asma Ahmed, assistant professor of epidemiology and prevention, found that preterm birth is linked to an increased risk of premature death that persists into the third and fourth decades of life.
"We found that the risk of early death is higher with a lower gestational age at birth, with those born before 28 weeks facing the highest risks," Ahmed explained. The mortality risk was most pronounced during infancy and early childhood but remained elevated throughout the follow-up period, which extended to age 36.
Multiple causes contributed to this increased mortality, including respiratory, circulatory, and digestive disorders; diseases of the nervous and endocrine systems; infections; cancers; and birth defects.
Global Implications
Preterm birth affects approximately 10% of all births worldwide and is the leading cause of infant mortality. It ranks as the second leading cause of death among children under five years of age.
These findings have significant implications for healthcare systems globally, particularly in low- and middle-income countries where preterm birth rates are highest. The researchers emphasize that clinical care during the newborn period, while crucial, must be complemented by long-term monitoring and support services.
Need for Comprehensive Support Systems
Both studies highlight the necessity of developing comprehensive support systems that extend beyond immediate medical care for preterm infants. These should include psychological, educational, and vocational resources designed to address the specific challenges faced by individuals born preterm.
As Dr. Ahmed noted, "Understanding the long-term effects of preterm birth can help us develop preventative strategies and identify interventions to improve the health of individuals who are born preterm."
The research underscores that preterm birth should be recognized not only as an acute medical challenge but as a significant risk factor for lifelong health and socioeconomic disparities, requiring sustained attention and resources from healthcare systems and policymakers alike.
