Preterm Birth Ups Mortality Risk in Young Adulthood

Low gestational age at birth tied to increased mortality risk in early childhood, young adulthood

WEDNESDAY, Sept. 21 (HealthDay News) -- Low gestational age at birth is associated with increased mortality in young adulthood, according to a study published in the Sept. 21 issue of the Journal of the American Medical Association.

Casey Crump, M.D., Ph.D., from Stanford University in California, and colleagues investigated the association between gestational age at birth and mortality in young adulthood in a cohort of 674,820 singleton infants born in Sweden from 1973 through 1979 who survived to age 1 year, including 27,979 born preterm (gestational age < 37 weeks). The participants were followed up to 2008.

The investigators found that 7,095 deaths occurred in 20.8 million person-years of follow-up. Gestational age at birth showed a strong inverse association with mortality in early childhood (ages 1 to 5 years), no association was observed in late childhood and adolescence (ages 6 to 17 years), and an inverse association reappeared in young adulthood (ages 18 to 36 years). In young adulthood, mortality rates (per 1,000 person years) stratified by gestational age at birth were 0.94, 0.86, 0.65, 0.46, and 0.54 for 22 to 27 weeks, 28 to 33 weeks, 34 to 36 weeks, 37 to 42 weeks (full-term) and 43 or more weeks, respectively. Compared with full-term births, preterm births, including late preterm births, were associated with increased mortality risk in young adulthood (adjusted hazard ratio, 1.31) Gestational age at birth had the strongest inverse association with mortality in young adulthood due to congenital anomalies and respiratory, endocrine, and cardiovascular disorders.

"Low gestational age at birth was independently associated with increased mortality in young adulthood," the authors write.

Abstract
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