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Neonatal multimorbidity and the phenotype of premature aging in preterm infants

Jonathan S Litt1,2,3, Mandy Brown Belfort4,5, Todd M Everson6

  • 1Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, USA. jlitt@bidmc.harvard.edu.

Pediatric Research
|October 25, 2024
PubMed

Insights

Preterm birth increases the risk of multimorbidity, the co-occurrence of multiple chronic conditions. This framework links neonatal multimorbidity to early aging, improving care for preterm infants.

Area of Science:

  • Neonatology
  • Developmental Pediatrics
  • Gerontology

Background:

  • Multimorbidity, the co-occurrence of multiple chronic conditions, is linked to aging, frailty, and poor functioning.
  • Children born preterm exhibit higher rates of multimorbidity in early life compared to term-born peers.
  • Neonatal multimorbidity is associated with diminished quality of life and functional outcomes, yet theoretical understanding is limited.

Purpose of the Study:

  • To propose a framework conceptualizing neonatal multimorbidity as a reflection of maturational vulnerability from preterm birth.
  • To integrate life course epidemiology and Developmental Origins of Health and Disease models.
  • To identify physiologic and social antecedents and biological underpinnings of neonatal multimorbidity for improved risk prediction and care.

Main Methods:

  • The study employs a conceptual framework integrating life course epidemiology and the Developmental Origins of Health and Disease models.
  • It examines the impact of neonatal intensive care unit exposures and post-discharge environments on health trajectories.
  • The framework considers early biologic and physical aging pathways.

Main Results:

  • Neonatal multimorbidity stems from maturational vulnerability associated with preterm birth.
  • Adverse exposures in the neonatal intensive care unit and disadvantaged post-discharge contexts can amplify negative health impacts.
  • Early biologic and physical aging pathways are crucial for understanding and improving long-term outcomes.

Conclusions:

  • Neonatal multimorbidity is an underrecognized threat to long-term health in preterm infants.
  • A novel framework incorporating multimorbidity, early cellular aging, and life course health development can enhance risk prediction, care planning, and therapeutics.
  • Understanding these pathways can lead to improved care and outcomes for preterm infants.

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