Study shows preemies can face lifelong woes

Being born prematurely can cause health problems that haunt people into adulthood and even affect their own children, a study shows.

Doctors have long known that premature babies are less likely to survive and thrive than those born at full-term, after an average pregnancy of 40 weeks.

However, a study in today's Journal of the American Medical Association shows that the health problems of premature babies don't end in childhood. People born preterm are also less likely to graduate from high school or have children of their own, the study shows.

Women born prematurely are at greater risk of themselves giving birth preterm or having stillborn children, and their babies have higher rates of death in the first year.

The earlier babies were born, the greater their risk of all these problems, according to the study, which included detailed records from more than 1 million Norwegians born between 1967 and 1988. The study "reminds us that prematurity is a very significant health problem that lasts a lifetime," said David Adamkin, a spokesman for the American Academy of Pediatrics, who was not involved in the paper.

In an editorial that accompanies the new study, researchers Melissa Adams and Wanda Barfield said doctors may better identify and manage chronic conditions if they know a patient was born prematurely.

Adamkin, the director of newborn medicine at the University of Louisville school of medicine, said the study reinforces the need to reduce preterm birth. The U.S. preterm birth rate — 12.7 percent — has increased 20 percent since 1990, according to the March of Dimes.

Researchers used the Norwegian registry because it provides a wealth of information on patients and their family members that isn't available in the United States, said co-author Geeta Swamy, a maternal-fetal medicine specialist at Duke University Medical Center.

The reasons for all the health troubles that beset people born preterm aren't always clear. For example, Swamy said doctors can't be certain why people born prematurely were less likely to have children. But she said it's possible that medical problems make them less likely to marry.

In their editorial, Adams and Barfield note that the majority of preterm children end up healthy and go on to have kids of their own.

And they note that medical advances allow doctors today to save many more premature babies than they could when the children in the study were born. For example, women in preterm labor today are often transferred from local hospitals to specialized medical centers with expertise in caring for high-risk newborns.

And since the 1990s, doctors have routinely given babies surfactant, which matures newborns' lungs, and given mothers steroids before delivery, which helps the lungs and decreases the risk of bleeding in the brain, Adamkin said.