Most children born prematurely survive to early- to mid-adulthood without major comorbidities

Reference

Crump C, Winkleby MA, Sundquist J, Sundquist K. Prevalence of survival without major comorbidities among adults born prematurely. JAMA 2019;322(16):1580-1588.

Synopsis

The prevalence of good health among adults born prematurely is uncertain. These investigators analyzed data obtained from multiple registries in Sweden that record births, deaths, outpatient and inpatient diagnoses, and pharmaceutical prescriptions. The information obtained for all live births (N = 2,574,537) occurring from 1973 to 1997 included gestational age at birth, survival without any major comorbidities (ie, asthma, hypertension, diabetes, kidney disease, mental disorders, cerebral palsy, and epilepsy), birth year, sex, fetal growth, multiple birth, maternal age at delivery, maternal education level, maternal smoking, and hypertensive disorders and diabetes during pregnancy. A total of 149,065 persons (5.8%) were born preterm of whom 94.2% survived to at least 18 years of age. Of the entire cohort, 62.1% were still alive without major comorbidities. Corresponding prevalence by gestational age at birth were 54.6% for all preterm, 22.3% for extremely preterm (22 - 27 weeks'), 48.5% for very preterm (28 - 33 weeks'), 58.0% for late preterm (34 - 36 weeks'), 61.2% for early term (37 - 38), and 63% for full-term. The most common comorbidity in the entire cohort was asthma. A co-sibling analysis to control for unmeasured shared familial factors did not change the results. Similarly, adjustments for other comorbidities had little effect on the reported findings.