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The extremely preterm young adult - State of the art
Neil Marlow1, Samantha Johnson2, John R Hurst3
1Neonatal Medicine, UCL Institute for Women's Health, University College London, London, UK.
Insights
Adults born at extremely low gestations often experience lasting health issues. However, most survivors achieve good societal participation, indicating persistent risks but also resilience.
Area of Science:
- Neonatal Medicine
- Developmental Pediatrics
- Longitudinal Studies
Background:
- Previous research often grouped extremely preterm infants with slightly more mature populations.
- Collaborative studies enhance confidence in identifying long-term risks for preterm infants.
- Understanding adult outcomes is crucial for contemporary cohorts born at extremely low gestations.
Purpose of the Study:
- To review and synthesize available data on adult outcomes for individuals born at extremely low gestations.
- To identify the persistence of adverse health outcomes into adulthood.
- To assess the long-term participation in society among extremely preterm survivors.
Main Methods:
- Systematic review of published literature.
- Inclusion of studies reporting outcomes into the third decade of life.
- Evaluation of a wide range of health outcomes across all body systems.
Main Results:
- Adverse outcomes persist into adult life for many individuals born extremely preterm.
- Most survivors are free from major disabling conditions and participate well in society.
- The prevalence of childhood impairments has not improved in contemporary cohorts, indicating ongoing risks.
Conclusions:
- Extremely preterm birth is associated with persistent adverse outcomes into adulthood.
- While significant challenges exist, many survivors achieve functional independence and societal integration.
- Further research is needed to define ageing trajectories and long-term health beyond the third decade.
Abstract:
Recently several studies have reported adult outcomes for individuals born at extremely low gestations, although they tend to be included as part of slightly more mature populations. The growth in collaborative studies allows greater confidence in the identification of persisting risk and allows us to have confidence in the likely outcomes in more contemporary cohorts. This review shows the persistence of adverse outcomes through to adult life and includes a range of outcomes including all body systems evaluated. Nonetheless adult outcomes demonstrate that most survivors appear to be free of major disabling conditions and demonstrate good participation in society. Several studies have reported outcomes in the third decade, but subsequent ageing trajectories have not yet been defined. The stability of many of the outcomes evaluated over childhood into adult life and the lack of improvement in prevalence of childhood impairments found in contemporary cohorts indicates persisting levels of risk.
