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A groundbreaking study led by the Liggins Institute in Auckland has provided new insights into the long-term health of individuals born preterm. The research, which followed adults who had been born preterm, found no significant differences in diabetes, prediabetes, or dyslipidemia, and even revealed that these individuals had fewer cardiovascular events compared to those born at term. However, a higher likelihood of developing high blood pressure by age 50 was observed among the preterm group.
Preterm birth, defined as occurring before 37 weeks gestation, affects around one in 10 births globally. Previous research has shown that preterm birth can increase the risk of cardiovascular disorders, including hypertension and stroke, though these studies typically did not include individuals who survived to midlife in the era of modern neonatal care.
The new study, titled Health Outcomes 50 Years After Preterm Birth in Participants of a Trial of Antenatal Betamethasone, published in Pediatrics, addresses this gap by providing a contemporary evaluation of the long-term health risks faced by preterm individuals. The study tracked participants from a double-blind, placebo-controlled trial of antenatal betamethasone conducted at the National Women’s Hospital in Auckland.
Participants, now adults, completed a health questionnaire and allowed researchers to review their health data. The study measured clinical endpoints such as hypertension, diabetes, prediabetes, treated dyslipidemia, and major adverse cardiovascular events. Secondary outcomes included respiratory health, mental health, educational attainment, and other health metrics.
Key findings from the study include:
- Over one-third of adults born preterm (34.7%) reported higher rates of high blood pressure compared to 19.8% of those born at term. However, the risk of major cardiovascular events was lower in the preterm group (2.8%) compared to the term-born group (6.9%).
- There were no significant differences in rates of diabetes, prediabetes, or treated dyslipidemia between the two groups.
- Respiratory health was largely similar between the preterm and term-born groups, and there were no notable differences in the prevalence of chronic kidney disease.
- Mental health outcomes were more favorable for preterm-born adults, with fewer individuals reporting mental health disorders (38.2% vs. 52.9%). Self-reported depression was also less common in this group.
- There was no significant difference in educational attainment or mortality after the first year of life between preterm and term-born individuals.
These findings suggest that while some long-term health risks, such as high blood pressure, are more common in individuals born preterm, the overall risk of cardiovascular disease and other major health issues may not be as elevated as previously thought. In particular, preterm birth at moderate gestation does not appear to universally lead to worsened cardiovascular outcomes.
The study’s authors emphasize the importance of the improvements in neonatal care, such as the use of antenatal corticosteroids, which have contributed to better long-term outcomes for individuals born preterm. These findings offer a more nuanced understanding of the potential health risks for preterm individuals as they reach midlife, shedding light on the complexity of long-term outcomes in this population.
For more information, see the full study: Health Outcomes 50 Years After Preterm Birth in Participants of a Trial of Antenatal Betamethasone, Pediatrics (2024). DOI: 10.1542/peds.2024-066929.
