A 35-year longitudinal study of U.S. adults born preterm reveals lasting consequences that go well beyond childhood.
Compared to peers born full-term, these individuals show higher rates of anxiety, elevated blood pressure, abnormal cholesterol levels, and reduced bone density—evidence that prematurity can cast a long physiological and psychological shadow. The study, published in JAMA Network Open, underscores the urgent need for adult medicine to routinely consider birth history during care.
Preterm Birth Isn’t Just a Pediatric Issue
Drawing from the RHODE study—the nation’s longest-running cohort of preterm births—researchers followed 158 preterm and 55 full-term individuals from infancy into their mid-thirties. They found that higher early life medical risk among preterm-born participants was strongly associated with internalizing mental health problems and several markers of cardiometabolic dysfunction.
Among the key findings at age 35:
- Higher systolic blood pressure: +7.15 mm Hg on average
- Lower HDL (“good”) cholesterol: −13.07 mg/dL
- Higher triglycerides: +53.97 mg/dL
- Higher abdominal fat ratio and lower bone mineral density
- Increased anxiety, depression, and somatic symptoms over time
“These results suggest that as the preterm-born population ages, it is increasingly important to understand their specific health needs to optimize health outcomes and health care resources,” the authors wrote.
A Missing Question in Adult Medicine
Despite decades of evidence linking preterm birth to lifelong health risks, few clinicians in adult primary care settings routinely ask about birth history. This oversight, the authors argue, perpetuates a dangerous myth: that prematurity is only a problem in childhood.
The data tell a different story. Preterm individuals in this study experienced a faster rise in anxiety-related symptoms from adolescence through age 35. And early medical severity—not social support or family income—was the strongest predictor of poor physical outcomes like reduced bone density and central fat accumulation.
Building Evidence from a U.S. Cohort
Much prior research on adult preterm health has come from Scandinavian or European populations. This study stands out by focusing on a diverse, U.S.-born cohort from a New England NICU between 1985 and 1989. All participants weighed under 1850 grams at birth, and the study followed them across ten data waves.
Higher childhood socioeconomic status was linked to lower adult levels of interleukin-6, an inflammatory marker. Yet SES did not significantly influence blood pressure or psychological outcomes—suggesting medical risk at birth may be the more potent determinant.
Looking Ahead: Health Systems Must Catch Up
With nearly 8 million adults in the U.S. estimated to have been born preterm, the study calls for a paradigm shift. Clinicians, policymakers, and public health leaders need to treat prematurity as a chronic condition—one that demands lifelong monitoring, tailored screenings, and evidence-based prevention strategies.
As the authors conclude, “A long-held misconception posits that prematurity is exclusively an issue of infancy… This belief has been dispelled by contemporary research, which demonstrates that preterm birth results in lifelong consequences.”
Journal: JAMA Network Open
DOI: 10.1001/jamanetworkopen.2025.22599
ScienceBlog.com has no paywalls, no sponsored content, and no agenda beyond getting the science right. Every story here is written to inform, not to impress an advertiser or push a point of view.
Good science journalism takes time — reading the papers, checking the claims, finding researchers who can put findings in context. We do that work because we think it matters.
If you find this site useful, consider supporting it with a donation. Even a few dollars a month helps keep the coverage independent and free for everyone.