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Preterm Birth and Risk of Health Service Use, Morbidity, and Medication Needs at 5 Years

Lindsay L Richter1, Ye Shen2, Sarka Lisonkova3

  • 1Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada.

JAMA Pediatrics
|September 8, 2025
PubMed

Insights

Children born preterm need more healthcare and face greater health challenges in their first five years, despite advances in neonatal care. This highlights the long-term impact of premature birth on health outcomes.

Area of Science:

  • Neonatal care and outcomes
  • Pediatric health services research
  • Population health

Background:

  • Neonatal intensive care has advanced significantly.
  • Premature birth continues to be a major cause of neonatal mortality and morbidity.
  • Long-term health outcomes for preterm infants require ongoing investigation.

Purpose of the Study:

  • To describe health service utilization, morbidity, and medication needs up to age 5 years in a contemporary cohort of children born preterm.
  • To quantify the association between gestational age at birth and health outcomes in early childhood.

Main Methods:

  • Population-based cohort study using linked administrative health and pharmacy data in British Columbia, Canada.
  • Included 448,819 children born between 2004 and 2014 with 5-year follow-up.
  • Analyzed gestational age at birth, health service use (hospitalizations, outpatient visits), morbidity diagnoses, and outpatient prescriptions.

Main Results:

  • Children born preterm had higher hospitalization rates and outpatient visits compared to those born at 39-41 weeks' gestational age.
  • Preterm birth was associated with increased risks of respiratory, endocrine, gastrointestinal, kidney, neurodevelopmental, and sleep disorders.
  • Preterm infants were more likely to receive outpatient antibiotics, bronchodilators, corticosteroids, diuretics, and thyroid hormones.

Conclusions:

  • Despite advances in neonatal care, children born preterm require more healthcare resources and experience greater health challenges in their first five years.
  • These findings underscore the critical need for continued support and monitoring of preterm infants beyond the neonatal period.
  • Gestational age at birth is a significant predictor of long-term health service use and morbidity in childhood.
Abstract

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