Preterm birth associated with diminished long-term survival, reproduction

Reproduction during adulthood was diminished for participants born preterm compared to those born at term. For men and women born at 22 to 27 weeks, absolute reproduction was 13.9 percent and 25 percent, with men being 76 percent less likely to reproduce; women, 67 percent less likely. For those born at 28 to 32 weeks, absolute reproduction was 38.6 percent and 59.2 percent for men and women, with lower rates of reproduction of 30 percent, and 19 percent, respectively. Preterm women but not men were at increased risk of having preterm offspring.

“In this study population, preterm birth was negatively associated with both long-term survival and reproduction. As the preterm birth survivorship continues to grow, further studies will show whether improvements in obstetric and neonatal care affect survival as well as reproductive capacity and long-term quality of life. Continued research aimed at elucidating causal pathways and better therapeutic approaches are imperative for successful strategies to prevent preterm birth,” the authors conclude.

(JAMA. 2008;299[12]:1429-1436. Available pre-embargo to the media at www.jamamedia.org)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Editorial: The Future of Very Preterm Infants - Learning From the Past

In an accompanying editorial, Melissa M. Adams, M.P.H., Ph.D., of RTI International, and Wanda D. Barfield, M.D., M.P.H., of the Centers for Disease Control and Prevention, Atlanta, comment on the findings of Swamy and colleagues.

“At present, clinicians can extend guarded optimism to the families of children who are born very preterm. The findings of Swamy et al illustrate that the survival of preterm infants—although lower than that of their term peers—improves to adulthood. Nonetheless, compared with their adult term peers, fewer adult preterm survivors reproduce. These risks should be interpreted cautiously because the majority of preterm infants have good health and good reproduction. Norway demonstrates better outcomes than the United States, which has persistent, stark racial disparities.”

“Because lifetime risk of poor health is increased among individuals who were born preterm, patients should inform their clinicians about their history of preterm birth. This information may help clinicians identify and manage childhood and adult chronic conditions. Clearly, population-based data on preterm delivery and its long-term consequences may be pertinent medical history for the nation’s future health.”

(JAMA. 2008;299[12]:1477-1478. Available pre-embargo to the media at www.jamamedia.org)

Editor’s Note: Please see the article for additional information, including financial disclosures, funding and support, etc.