Born too early, still felt it at the age of 35

A 35-year longitudinal study of premature birth in the United States showed that the lasting consequences far exceeded childhood.

These people show higher anxiety rates, elevated blood pressure, abnormal cholesterol levels, and reduced bone density than their mature peers – premature birth can cause long-term physiological and psychological shadows. The study was published in JAMA Network Openhighlighting the urgent need for adult medicine to regularly consider birth history during nursing.

Premature birth is not only a child problem

Drawing from Rhode’s study, the longest premature birth population in the country, researchers tracked 158 premature births and 55 intact people, from infancy to their thirties. They found that participants born prematurely had higher early life risks, which were closely related to intrinsic mental health problems and several markers of cardiac metabolic dysfunction.

Among the main findings at the age of 35:

• Higher systolic pressure: average +7.15 mm Hg
• Under HDL (“good”) cholesterol: -13.07 mg/dl
• Higher triglycerides: +53.97 mg/dl
• Higher abdominal fat ratio and lower bone mineral density
• Over time, anxiety, depression and physical symptoms increase

“These results suggest that as the population who are born prematurely ages, it becomes increasingly important to understand their specific health needs to optimize health outcomes and health care resources,” the authors wrote.

The problem of missing in adult medicine

Despite decades of evidence linking premature birth to lifelong health risks, few clinicians usually ask about birth history in adult primary care settings. The author believes that this negligence perpetuates a dangerous myth: premature birth is only a problem in childhood.

The data tells a different story. Patients with premature birth in this study increased more rapidly from puberty to 35 years of age. Early medical severity (not social support or family income) is the strongest predictor of adverse physical outcomes, such as reduced bone density and accumulation of central fat.

Establish evidence from the US cohort

Many previous studies on premature birth in adults are from the Scandinavian or European population. This study highlights the diverse, New England-born study of NICUs between 1985 and 1989. All participants were born with weights below 1850 grams, and the study followed them for ten waves of data.

Higher childhood socioeconomic status was associated with lower levels of adult interleukin-6 with markers of inflammation. However, SES did not significantly affect blood pressure or psychological outcomes—medical risk at birth may be a more effective determinant.

Looking to the future: Health systems must catch up

The study estimated that nearly 8 million adults were born prematurely and therefore required a paradigm shift. Clinicians, policy makers and public health leaders need to view premature birth as a chronic disease – lifelong surveillance, tailored screening and evidence-based prevention strategies are required.

As the authors concluded: “The long-standing misunderstanding that premature birth is entirely an infancy problem…this belief has been eliminated by contemporary institutes, which suggests that premature birth can lead to lifelong consequences.”

Magazine: JAMA Network Open
doi: 10.1001/jamanetworkopen.2025.22599

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