Adults born preterm: A review of general health and system-specific outcomes
Abstract
In this review of 126 publications, we report that an overwhelming majority of adults born at preterm gestations remain healthy and well. However, a small, but a significant fraction of them remain at higher risk for neurological, personality and behavioural abnormalities, cardio-pulmonary functional limitations, systemic hypertension and metabolic syndrome compared to their term-born counterparts. The magnitude of increased risk differed across organ systems and varied across reports. The risks were proportional to the degree of prematurity at birth and seemed to occur more frequently among preterm infants born in the final two decades of the 20th century and later. These findings have considerable public health and clinical practice relevance. CONCLUSION: Preterm birth needs to be considered a chronic condition, with a slight increase in the risk for long-term morbidities among adults born preterm. Therefore, obtaining a history of gestational age and weight at birth should be a routine part of care for patients of all age groups.
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The long-term consequences of prematurity are multisystemic, extending well beyond the cardiovascular domain.
“Adult metabolic and renal outcomes further reinforce the understanding that the long-term consequences of prematurity are multisystemic, extending well beyond the cardiovascular domain [107,108,109].”
From Placental Pathophysiology and Developmental Programming of Adult Cardiometabolic Risk: A Narrative Review of Pregnancy Exposures (2026) · cites this paper as [107]
Cites
Prevention of recurrent preterm delivery by 17 alpha–hydroxyprogesterone caproate
Meis, P. J., Klebanoff, M., Thom, E., Dombrowski, M. P., Sibai, B., Moawad, A. H., Spong, C. Y., Hauth, J. C., Miodovnik, M., Varner, M. W., et al. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa035140 · Cited by 1,555 · see citing works
Neurodevelopmental Outcome After Extreme Prematurity: A Review of the Literature
Jarjour, I. T. (2015) · Pediatric Neurology · doi:10.1016/j.pediatrneurol.2014.10.027 · Cited by 299 · see citing works
Preterm birth and structural brain alterations in early adulthood
Nosarti, C., Nam, K. W., Walshe, M., Murray, R. M., Cuddy, M., Rifkin, L., & Allin, M. P. G. (2014) · NeuroImage: Clinical · doi:10.1016/j.nicl.2014.08.005 · Cited by 213 · see citing works
Risk of Diabetes Among Young Adults Born Preterm in Sweden
Crump, C., Winkleby, M. A., Sundquist, K., & Sundquist, J. (2011) · Diabetes Care · doi:10.2337/dc10-2108 · Cited by 114 · see citing works
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An overview of adult health outcomes after preterm birth
Crump, C. (2020) · Early Human Development · doi:10.1016/j.earlhumdev.2020.105187 · Cited by 273 · see citing works
Psychological and Physical Health of a Preterm Birth Cohort at Age 35 Years
D’Agata, A. L., Eaton, C., Smith, T., Vittner, D., Sullivan, M. C., Granger, D. A., Lu, B., & Parent, J. (2025) · JAMA Network Open · doi:10.1001/jamanetworkopen.2025.22599 · Cited by 13 · see citing works
Panteris, E., Kakatsaki, I., Koukou, Z., Kolvatzis, C., Papanikolaou, S., & Hatzidaki, E. (2026) · Pathophysiology · doi:10.3390/pathophysiology33030067
- Authors
- Raju, T. N. K., Buist, A. S., Blaisdell, C. J., Moxey-Mims, M., & Saigal, S.
- Affiliations
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (US)
- Oregon Health & Science University (US)
- National Institutes of Health (US)
- National Institute of Diabetes and Kidney Diseases; Bethesda MD USA
- McMaster University (CA)
- Corresponding author
- Raju, Tonse N. K.
- ORCID
- Raju, Tonse N. K.
- Venue
- Acta Paediatrica
- Publisher
- Wiley
- Published
- 2017-05-17
- Volume
- 106
- Issue
- 9
- Pages
- 1409-1437
- ISSN
- 0365-1436 (ISSN-L)
- 0803-5253
- OpenAlex
- W2605921691
- Cited by
- 275
- References
- 4
- Citations by year
- 2026: 17 · 2025: 20 · 2024: 26 · 2023: 51 · 2022: 27 · 2021: 37 · 2020: 38 · 2019: 29 · 2018: 20 · 2017: 10
- FWCI
- 4.97
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Acta Paediatrica (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Neonatal Respiratory Health Research
- Keywords
- preterm birth, long-term health effects, neurological abnormalities, systemic hypertension, metabolic syndrome, gestational age, birth weight
- MeSH terms
- Adult, Humans, Human Development, Infant, Newborn, Infant, Premature, Diseases, Premature Birth
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