Long-term health risks linked to preterm birth

Long-term health risks linked to preterm birth | Image Credit: © Chinnapong - © Chinnapong - stock.adobe.com.

Preterm birth has been linked to stress which can cause adverse health outcomes later in life, according to a recent study by University of Rhode Island College of Nursing researchers.¹

According to investigators, these complications highlight a need to include birth history in medical records and clinical guidelines for adults. Further research will focus on epigenetic age acceleration in patients born preterm, providing another potential avenue of understanding long-term health in this population.¹

“For individuals who have medical complications early in life, we are now seeing an increased risk of different chronic health issues later in life,” said Amy D’Agata, professor at the University of Rhode Island College of Nursing. “We are now realizing that there is a very strong link between what happens to you early in life and later health outcomes.”¹

Assessing adult health after preterm birth

The study was conducted to evaluate psychological and physiological health in adults with a history of preterm birth.² Comprehensive data was obtained at the clinical research facility and included physiological measurements, biospecimens, performance-based tasks, imaging studies, and survey responses.

Self-reported demographics were also collected from participants. Participants included individuals born preterm between 1985 and 1989, with a birthweight below 1850 g and certain neonatal diagnoses. Those who were critically ill or had low survival probabilities were excluded. Healthy, normal-weight, full-term infants were also recruited as controls.²

Internalizing and externalizing problems were measured using the Achenbach System of Empirically Based Assessment. At year 17 of follow-up, data was collecting through Youth Self-Report, while Adult Self-Report was obtained at years 23 and 35 of follow-up.²

Additional health and social assessments

During these follow-up periods, anxious, depressed, and withdraw behavior were assessed through broadband internalizing scales, while externalizing scales were used to assess aggressive behavior, rule-breaking, and intrusiveness. Blood pressure measurements were obtained 3 times after 5 minutes of seated rest.²

Additional measures included blood specimens after at least 9 hours of fasting, body fat distribution and bone density image using dual x-ray absorptiometry, and cumulative medical risk across multiple follow-up assessments. Assessments in the home allowed proximal social factors to be indexed, and socioeconomic risk was analyzed at each time point.²

There were 158 preterm and 55 full-term born adults aged a mean 35 years included in the analysis, 50.2% of whom were female, 8% Black, 4.2% Hispanic, and 87.3% White. Similar sex, age, and race distribution was reported between preterm vs full-term births, but preterm births had lower socioeconomic status (SES).²

Mental and physiological health outcomes

Preterm birth occurred between 24- and 36-weeks’ gestation, with infants born between 640 and 1820 g. These patients presented with an increase in adult internalizing problems, with a β value of 0.85. However, no associations with externalizing trajectories were reported. Correlations were also not found for social protection or childhood SES.²

Increased adulthood systolic blood pressure was reported in patients born preterm, with a β value of 7.15. However, no association was found for diastolic blood pressure. Social protection and childhood SES did not impact these outcomes.²

Similarly, higher triglycerides were reported in patients with increased medical risk severity. Childhood SES covariates did not influence these outcomes but was linked to lower interleukin 6 levels. These levels were not impacted by medical risk and social protection levels.²

Implications

Medical risk severity was also linked to an increase in android-to-gynoid fat ratio, with a β value of 0.22. Overall, the results highlighted increased mental health, cardiometabolic, and body composition risks in adults born preterm.²

“We are urging that birth history be included as a standard question on every adult intake form,” said D’Agata.¹ “Health cannot be fully optimized if we overlook such a critical assessment piece.”

References

1. Preterm birth can cause health problems later in life, should be considered in adult health records, URI study shows. University of Rhode Island. August 4, 2025. Accessed August 12, 2025. https://www.eurekalert.org/news-releases/1093533.
2. D’Agata AL, Eaton C, Smith T, et al. Psychological and physical health of a preterm birth cohort at Aage 35 years. JAMA Netw Open. 2025;8(7):e2522599. doi:10.1001/jamanetworkopen.2025.22599