Preterm birth and mortality in adulthood: a systematic review

Area of Science:

• Perinatal Epidemiology
• Public Health
• Longitudinal Cohort Studies

Background:

• Preterm birth affects nearly 11% globally, with high survival rates into adulthood.
• Improved neonatal care for preterm infants raises concerns about long-term health outcomes and adult mortality risks.

Purpose of the Study:

• To systematically review evidence on the association between preterm birth and adult mortality.
• To assess if preterm birth increases all-cause and cause-specific mortality in adulthood.

Main Methods:

• Systematic review of eight studies with over 6.5 million participants.
• Analysis of gestational age at birth in relation to mortality at ages 18 years and older.
• Inclusion of studies assessing sociodemographic, perinatal, maternal, and familial factors.

Main Results:

• Six recent studies (post-1967) show a positive association between preterm birth and adult all-cause mortality (ages 18-45).
• Adjusted relative risks for preterm birth ranged from 1.2 to 1.6; extremely preterm birth showed higher risks (1.9-4.0).
• Associations were found with respiratory, cardiovascular, endocrine, and neurological causes of death, independent of other factors.

Conclusions:

• Premature birth over the past 50 years is associated with a modest increase in early to mid-adulthood mortality.
• The findings highlight the long-term health implications of preterm birth, extending beyond infancy.
• Further research may be needed to understand the mechanisms driving these increased mortality risks.