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Long-term growth and general health for the tiniest or most immature infants

Gehan Roberts¹, Jeanie L Y Cheong²

¹Premature Infant Follow-up Program at the Royal Women's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Murdoch Childrens Research Institute, Melbourne, Australia.

Seminars in Fetal & Neonatal Medicine

|December 3, 2013

Insights

Infants born extremely preterm (EP) face lasting growth disadvantages and increased health issues into adulthood. Despite challenges, EP young adults report similar quality of life to their term-born peers.

Area of Science:

Neonatology
Developmental Pediatrics
Public Health

Background:

Improving survival rates for extremely preterm (EP) infants necessitate understanding long-term growth and health outcomes.
EP individuals exhibit distinct growth trajectories and health profiles compared to term-born individuals.

Purpose of the Study:

To comprehensively review the growth, health, and quality of life outcomes for individuals born extremely preterm into young adulthood.
To inform surveillance and intervention strategies for optimizing the long-term wellbeing of the EP population.

Main Methods:

Systematic review of existing literature on extremely preterm birth outcomes.
Analysis of growth parameters (height, weight), health conditions, hospital readmissions, bone health, metabolic risks, and quality of life.

Main Results:

EP individuals show persistent height deficits and higher rates of health concerns, medical conditions, and visual impairment.
Increased hospital readmissions in early childhood, primarily due to respiratory illness, and reduced bone health are noted.
Despite health risks, EP young adults report quality of life comparable to term-born counterparts.

Conclusions:

Long-term monitoring and targeted interventions are crucial for managing the health risks associated with extremely preterm birth.
Understanding these outcomes is essential for healthcare planning and improving the lifelong health trajectory of EP individuals.

Read full analysis

Abstract:

Given the improving survival rates of extremely preterm (EP, gestational age <28 weeks) infants, there is a need to understand their general growth and health outcomes not only in childhood, but also into adulthood. EP children are shorter and lighter compared with term children at term-equivalent age; with time, the weight disadvantage diminishes but the height disadvantage remains relatively unchanged. EP children and young adults also have higher rates of reported health concerns, medical conditions and visual impairment. Hospital readmissions are higher in early childhood, mostly attributed to respiratory illness. Individuals born EP have reduced bone health and are at increased risk for metabolic disorders. Increased rates of conditions such as diabetes or pathological fractures are not reported in the literature, although follow-up studies so far have only tracked EP individuals into young adulthood. Consequently, health care utilization and costs are increased in EP children and young adults. A thorough knowledge of the health risks related to EP birth is essential in planning surveillance and intervention strategies to optimize their health and wellbeing. Despite the increased risk of health problems, EP young adults generally report their quality of life to be similar to that reported in their term counterparts.

Keywords:

Extremely preterm Growth Health

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