Preterm birth is linked to later lung, kidney, and heart disease
A 2020 clinical review of published studies reports that people born preterm face a higher risk of lung, kidney, heart, and metabolic disease in adulthood. The authors gather evidence on the lungs, kidneys, heart, brain, and hormones in adults born before 37 weeks.
Key Findings
People born prematurely have a 4-fold higher incidence of asthma.
A Swedish study with 40 years of follow-up found adults born before 37 weeks faced double the risk of chronic kidney disease relative to term-born controls.
Adults ages 30 to 43 born before 37 weeks had a 53% higher relative risk of ischemic heart disease than a full-term birth cohort.
Metabolic syndrome was 2.5 to 4 times more likely in adults born preterm than in those born full-term, a pattern that included late preterm births.
Swedish data on ages 18 to 43 years showed 55% of preterm-born adults and 63% of full-term-born adults alive with no major comorbidities.
Interpretation
The article is a clinical review by two University of Miami physicians. The authors summarize published cohort studies, meta-analyses, and small studies. The text does not describe how the studies were chosen. Many of the results come from cohort studies, which report associations. The authors say research on long-term effects is limited and note that many population-based studies use Scandinavian data from before antenatal steroids. The authors call for more research in children and adults born this century. No medical society guidelines cover screening of adults born prematurely.
RRM Context
The authors name older mothers as one reason prematurity is rising. Assisted reproductive technologies are another, because they lead more often to multiple gestations and higher-risk pregnancies. Restorative reproductive medicine looks for the cause of infertility and treats it. The review reports links between birth timing and later health.
Our editorial summary of this paper, not the article's abstract.
Abstract
Due to a shortened period of in utero organ development, premature infants are at higher risk of chronic respiratory, cardiac, renal, and endocrine system disorders later in life. With more premature babies being born and more of them surviving, internists and primary care practitioners should be aware of their patient's birth history and of the potential long-term effects of prematurity. Such understanding can lead to early detection of disease and targeted lifestyle modifications.