Risk of Diabetes Among Young Adults Born Preterm in Sweden
Open accessAbstract
OBJECTIVE: Previous studies have suggested that preterm birth is associated with diabetes later in life. These studies have shown inconsistent results for late preterm births and have had various limitations, including the inability to evaluate diabetic outpatients or to estimate risk across the full range of gestational ages. Our objective was to determine whether preterm birth is associated with diabetes medication prescription in a national cohort of young adults. RESEARCH DESIGN AND METHODS: This was a national cohort study of 630,090 infants born in Sweden from 1973 through 1979 (including 27,953 born preterm, gestational age <37 weeks), followed for diabetes medication prescription in 2005-2009 (ages 25.5-37.0 years). Medication data were obtained from all outpatient and inpatient pharmacies throughout Sweden. RESULTS: Individuals born preterm, including those born late preterm (gestational age 35-36 weeks), had modestly increased odds ratios (ORs) for diabetes medication prescription relative to those born full term, after adjusting for fetal growth and other potential confounders. Insulin and/or oral diabetes medications were prescribed to 1.5% of individuals born preterm compared with 1.2% of those born full term (adjusted OR 1.13 [95% CI 1.02-1.26]). Insulin without oral diabetes medications was prescribed to 1.0% of individuals born preterm compared with 0.8% of those born full term (1.22 [1.08-1.39]). CONCLUSIONS: Preterm birth, including late preterm birth, is associated with a modestly increased risk of diabetes in young Swedish adults. These findings have important public health implications given the increasing number of preterm births and the large disease burden of diabetes, particularly when diagnosed in young adulthood.
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Young adults born preterm have higher diabetes risk, with evidence of a gestational-age gradient.
“A Swedish cohort study reported higher diabetes risk in young adults born preterm, with evidence of a gestational-age gradient, suggesting that early delivery may contribute to long-term metabolic vulnerability that may be evident by early adulthood [110].”
From Placental Pathophysiology and Developmental Programming of Adult Cardiometabolic Risk: A Narrative Review of Pregnancy Exposures (2026) · cites this paper as [110]
The Results report higher odds of diabetes medication prescription among young Swedish adults born preterm than among those born full term. They do not establish a consistent gestational-age gradient: odds were highest for the extremely preterm group but imprecise, and the authors report little difference between the 29–34- and 35–36-week groups. (LLM, conf=0.88)
Experimental — accuracy not yet measuredEarly delivery may contribute to long-term metabolic vulnerability evident by early adulthood.
“A Swedish cohort study reported higher diabetes risk in young adults born preterm, with evidence of a gestational-age gradient, suggesting that early delivery may contribute to long-term metabolic vulnerability that may be evident by early adulthood [110].”
From Placental Pathophysiology and Developmental Programming of Adult Cardiometabolic Risk: A Narrative Review of Pregnancy Exposures (2026) · cites this paper as [110]
The Results (page unavailable) and Conclusions (page unavailable) report increased diabetes risk among young Swedish adults born preterm, supporting the suggestion of vulnerability evident by early adulthood. The cited sentence overstates the gestational-age gradient: the Results say odds were highest for the extremely preterm group but imprecisely estimated, with little difference in risk estimates between 29–34 and 35–36 weeks. (LLM, conf=0.86)
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- Authors
- Crump, C., Winkleby, M. A., Sundquist, K., & Sundquist, J.
- Affiliations
- Stanford University (US)
- Lund University (SE)
- Corresponding author
- Crump, Casey
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2011-04-20
- Volume
- 34
- Issue
- 5
- Pages
- 1109-1113
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- PMC
- PMC3114485
- OpenAlex
- W2110902903
- Cited by
- 114
- References
- 27
- Citations by year
- 2026: 5 · 2025: 3 · 2024: 5 · 2023: 8 · 2022: 7 · 2021: 8 · 2020: 13 · 2019: 10 · 2018: 12 · 2017: 10 · 2016: 3 · 2015: 8 · 2014: 7 · 2013: 5 · 2012: 5
- FWCI
- 6.22
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Diabetes Care (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Lund University Publications (Lund University) (submittedVersion)
- Funders
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD052848)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Birth, Development, and Health
- Health Sciences › Medicine › Obstetrics and Gynecology › Gestational Diabetes Research and Management
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Keywords
- preterm birth, late preterm birth, diabetes risk, young adults, insulin, oral antidiabetic drugs, gestational age, fetal growth, cohort studies
- MeSH terms
- Diabetes Mellitus, Female, Gestational Age, Humans, Male, Risk Factors, Sweden, Premature Birth
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