Premature birth found to have long-term effects

Infants born prematurely are much more likely to die during childhood and, if they survive, much less likely to have children of their own in adulthood, according to the largest study of prematurity ever undertaken.

Researchers already knew that premature infants faced many neurological and developmental problems, but the new findings, released today, indicate that the spectrum of problems is even broader than suspected and persist throughout the child’s lifetime.

The study, conducted using Norwegian birth data, suggests that, as the percentage of premature infants who make it through their first year continues to grow because of advances in neonatology, the number of troubled infants and adults will also rise.

One in eight U.S. infants are born prematurely, a total of more than half a million per year, despite the best efforts of physicians to bring more pregnancies to full term – defined as 38 weeks or longer.

Researchers are not sure why the U.S. rate is so high, but contributing factors include the growing incidence of assisted reproduction, which often produces twins or triplets, which are more likely to be born prematurely.

There is also a rising incidence of deliberately induced premature deliveries and Cesarean sections.

The consequences can be devastating, particularly for very early births. They include learning disabilities, neurological problems, lung diseases and cerebral palsy.

Using Norway’s extensive registry of births and medical care, Swamy and her colleagues studied all 1,167,506 singleton births in that country between 1967 and 1988, following the children through 2002. They also looked at educational achievement and reproduction in the group born between 1967 and 1976.

A total of 5.2 percent of the births were premature, less than half the percentage in the U.S.

For boys born the most prematurely, between 22 and 27 weeks, their risk of death was 5.3 times normal between the ages of 1 and 6 and seven times normal between 7 and 13. For boys born between 28 and 32 weeks, the risk of death was 2.5 times normal in early childhood and 2.3 times normal in late childhood.

The most premature girls had 9.7 times the normal risk of death between ages 1 and 6, but no increased risk between 7 and 13. Girls born between 28 and 32 weeks did not have a significantly increased risk of death.

In adulthood, boys born the most prematurely were 76 percent less likely to reproduce, with only about one in seven having children. Women were 67 percent less likely to reproduce, with one in four having children.