Not just a childhood problem: Premature babies have a high mortality risk up to age 36

Babies born prematurely have a higher mortality risk than full-term babies not only during their first years of life, but up to the age of 36, concludes a new study involving a doctor from the Montreal Children's Hospital.This confirms that prematurity has an impact on all organs and shows that the greater risk of death does not dissipate after the first few years of life, said Dr. Marc Beltempo, a neonatologist at the hospital.“We see that premature babies have almost three times the risk of death than full-term babies at ages one to five, and that's really attributable to babies who are extremely premature,” he said.“But we also see that premature babies who survive to adulthood still have almost 30% more risk of death than someone who was born at term.”The researchers analyzed a cohort of some five million live births in Canada between 1983 and 1996. Just under 7% of these births were premature. Subjects were followed until 2019, i.e., for a period ranging from 23-to-36 years.Premature births were classified into gestational age subcategories: 24-to-27 weeks, 28-to-31 weeks, 32-to-33 weeks and 34-to-36 weeks, and compared with full-term births, 37-to-41 weeks.The researchers found an association between prematurity and an increased risk of death in all age groups up to 36 years, with the highest risks observed from birth to infancy (0-to-11 months) and early childhood (one to five years).The study also highlighted increased mortality risks associated with several causes, such as disorders of the respiratory, circulatory and digestive systems; diseases of the nervous, endocrine and infectious systems; cancers; and congenital malformations.That said, Dr Beltempo pointed out, the risk of death between the ages of 30 and 40 is very low to begin with.“An increase of about 30% may look big on paper,” he said. “But at the same time the baseline risk isn't very high, but it's still a difference that's important.”Premature babies will therefore carry with them a higher risk of various health problems, he added. In concrete terms, instead of starting screening for hypertension at the age of 40 or 50, it could be relevant to do so earlier in a patient born prematurely, he cited as an example.A study in Sweden has shown that cardiovascular risk is much higher in former premature infants than in non-premature infants, said Dr. Beltempo. "We therefore need to adapt our recommendations regarding cardiovascular risk to integrate the concept of prematurity.”Prematurity then becomes a risk factor that would justify a different screening strategy for various health problems, he believes. This need is all the more pressing given that, in the 1980s, about one baby in two born after 24 weeks of pregnancy died within a few days of delivery, pointed out Dr. Beltempo. Today, 75% of babies born at 24 weeks survive to the time of discharge.“The first cohorts of people who survived after a birth at 24 weeks date back to the 1980s or 1990s,” said Dr. Beltempo. “We need to start incorporating this into followup recommendations. (Premature babies) aren't born disabled, but their organs are immature and we need to (take into account) that immaturity because there are good prevention strategies to give them quality of life.”The findings were published in the medical journal JAMA Network Open.

Not just a childhood problem: Premature babies have a high mortality risk up to age 36

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