Cited by 265Birth, Development, and HealthInfant Development and Preterm CareChronic Kidney Disease and Diabetes

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Preterm birth and risk of chronic kidney disease from childhood into mid-adulthood: national cohort study

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Crump, Casey, Sundquist, Jan, Winkleby, Marilyn A, Sundquist, Kristina·2019·BMJ

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Abstract

Objective: To investigate the relation between preterm birth (gestational age <37 weeks) and risk of CKD from childhood into mid-adulthood. Design: National cohort study. Setting: Sweden. Participants: 4 186 615 singleton live births in Sweden during 1973-2014. Exposures: Gestational age at birth, identified from nationwide birth records in the Swedish birth registry. Main outcome measures: CKD, identified from nationwide inpatient and outpatient diagnoses through 2015 (maximum age 43 years). Cox regression was used to examine gestational age at birth and risk of CKD while adjusting for potential confounders, and co-sibling analyses assessed the influence of unmeasured shared familial (genetic or environmental) factors. Results: 4305 (0.1%) participants had a diagnosis of CKD during 87.0 million person years of follow-up. Preterm birth and extremely preterm birth (<28 weeks) were associated with nearly twofold and threefold risks of CKD, respectively, from birth into mid-adulthood (adjusted hazard ratio 1.94, 95% confidence interval 1.74 to 2.16; P<0.001; 3.01, 1.67 to 5.45; P<0.001). An increased risk was observed even among those born at early term (37-38 weeks) (1.30, 1.20 to 1.40; P<0.001). The association between preterm birth and CKD was strongest at ages 0-9 years (5.09, 4.11 to 6.31; P<0.001), then weakened but remained increased at ages 10-19 years (1.97, 1.57 to 2.49; P<0.001) and 20-43 years (1.34, 1.15 to 1.57; P<0.001). These associations affected both males and females and did not seem to be related to shared genetic or environmental factors in families. Conclusions: Preterm and early term birth are strong risk factors for the development of CKD from childhood into mid-adulthood. People born prematurely need long term follow-up for monitoring and preventive actions to preserve renal function across the life course.

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Authors: Crump, C., Sundquist, J., Winkleby, M. A., & Sundquist, K.
Affiliations: Icahn School of Medicine at Mount Sinai (US)
Lund University (SE)
Stanford University (US)
Corresponding author: Crump, Casey
ORCID: Crump, Casey
Sundquist, Jan
Sundquist, Kristina
Venue: BMJ
Publisher: BMJ
Published: 2019-05-01
Volume: 365
Pages: l1346
ISSN: 1756-1833 (ISSN-L)
0959-8138
DOI: 10.1136/bmj.l1346
PMC: PMC6490674
OpenAlex: W2942751913
Cited by: 265
References: 59
Citations by year: 2026: 29 · 2025: 38 · 2024: 32 · 2023: 38 · 2022: 29 · 2021: 42 · 2020: 40 · 2019: 16
FWCI: 33.01
Type: journal article
Language: en
Open access: hybrid
doi.org
Licence: cc-by-nc
www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
Locations: BMJ (publishedVersion, cc-by-nc)
Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
PubMed Central (publishedVersion, cc-by-nc)
PubMed (publishedVersion)
Lund University Publications (Lund University) (submittedVersion)
HighWire Press Open Archive (submittedVersion)
Funders: Hjärt-Lungfonden
Vetenskapsrådet
National Heart, Lung, and Blood Institute (R01HL139536)
Topics: Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
Keywords: preterm birth, chronic kidney disease, extremely preterm birth, early term birth, gestational age, childhood, midlife, risk factors, birth cohort, kidney disease prevention, long-term follow-up, Sweden, birth registry, sex differences, neonatal intensive care, neonatal sepsis
MeSH terms: Adolescent, Adult, Child, Child, Preschool, Female, Gestational Age, Humans, Infant, Infant, Newborn, Male, Pregnancy, Risk Factors, Sweden, Early Diagnosis, Premature Birth, Renal Insufficiency, Chronic, Young Adult

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Preterm birth and risk of chronic kidney disease from childhood into mid-adulthood: national cohort study

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