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Published on: August 25, 2014
Prematurity, smallness-for-gestational age and later hospital admissions: a nation-wide registry study
Rasmus Á Rogvi1, Julie Lyng Forman2, Gorm Greisen1
1Department of Neonatology, Copenhagen University Hospital, Copenhagen, Denmark.
Insights
Infants born premature or small for gestational age (SGA) face altered risks for numerous diseases throughout life. This large-scale study reveals significant associations across most organ systems, impacting childhood and early adulthood.
Area of Science:
- Epidemiology
- Public Health
- Pediatrics
Background:
- Premature birth and small for gestational age (SGA) are linked to later-life health issues like gestational diabetes, hypertension, and pre-eclampsia.
- This study investigates the broader association between premature birth or SGA and all diagnosed diseases during hospital admissions.
Purpose of the Study:
- To examine the association between being born premature or small for gestational age (SGA) and the risk of hospital-diagnosed diseases later in life.
- To identify specific disease categories and novel associations linked to early-life growth and birth timing.
Main Methods:
- Utilized Danish nationwide registries to form a cohort of 1,348,106 individuals born between 1974-1996.
- Analyzed 27,910,558 hospital admissions from 1994-2007, assessing diagnoses using multivariate logistic regression.
- Included diagnoses with at least 100 occurrences, resulting in 4,175 codes for analysis.
Main Results:
- Out of 4,175 analyzed diagnoses, 250 showed statistically significant associations with premature birth or SGA after multiple testing correction.
- Affected diseases spanned multiple organ systems, including cardiovascular, endocrine, infectious, neurological, psychiatric, and respiratory conditions.
- Novel findings included increased risks for delayed puberty and neurofibromatosis type 1, and decreased risks for mononucleosis and certain fractures.
Conclusions:
- Being born premature or SGA is associated with significantly altered risks for a wide spectrum of hospital-diagnosed diseases.
- These associations manifest across nearly all organ systems and persist throughout childhood and early adulthood.
- Findings warrant further investigation in other cohorts and exploration of underlying pathogenic mechanisms.
Introduction:
Being born premature or small for gestational age (SGA) is known to be associated with diseases later in life, such as gestational diabetes, hypertension and pre-eclampsia. In this study we examined the association between being born premature or SGA and all diseases diagnosed during hospital admissions later in life.
Methods:
Using Danish nation-wide registries we created a cohort of 1,348,106 persons born 1974-1996 and assessed all unique diagnoses registered in the Danish Patient Registry (DPR) for hospital admissions in the period 1994-2007 (n=27,910,558). We determined the odds ratios for persons born premature or SGA using multivariate logistic regression.
Results:
A total of 15,059 unique ICD-10 diagnosis codes were represented in the period. Only diagnoses used at least 100 times were included in the analysis (n=4175). Of these 838 showed an odds ratio that was statistically significantly different from unity for people born premature or SGA. After correcting for multiple testing, 250 remained significant. The diagnoses covered diseases in most organ systems, including cardiovascular, endocrinological, infectious, neurological/neurosurgical, obstetric, orthopedic, psychiatric, lung & urological diseases, and occurred throughout childhood and early adulthood. Novel findings included increased risks for delayed puberty, neurofibromatosis type 1 and ileus and decreased risks of mononucleosis, peritonsillar abscesses, chronic hypothyroidism and several types of fractures and contusions later in life.
Conclusion:
Being born premature or SGA was associated with significantly altered risks of being admitted to a hospital with a wide range of diseases later in life, affecting almost all organ systems throughout childhood and early adulthood. Our findings may motivate testing in other cohorts and search for novel mechanisms of pathogenesis.
