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Preterm birth and risk of chronic kidney disease from childhood into mid-adulthood: national cohort study
Open accessAbstract
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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“In another national cohort, preterm birth was associated with an increased risk of chronic kidney disease from childhood through mid-adulthood, supporting the link between reduced nephron endowment, altered renal development and later hypertension and cardiometabolic risk [111].”
From Placental Pathophysiology and Developmental Programming of Adult Cardiometabolic Risk: A Narrative Review of Pregnancy Exposures (2026) · cites this paper as [111]
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“In another national cohort, preterm birth was associated with an increased risk of chronic kidney disease from childhood through mid-adulthood, supporting the link between reduced nephron endowment, altered renal development and later hypertension and cardiometabolic risk [111].”
From Placental Pathophysiology and Developmental Programming of Adult Cardiometabolic Risk: A Narrative Review of Pregnancy Exposures (2026) · cites this paper as [111]
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Metadata
- 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
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2019-05-01
- Volume
- 365
- Pages
- l1346
- ISSN
- 1756-1833 (ISSN-L)
- 0959-8138
- 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
- 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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