Almost any women in her eighth month of pregnancy will tell you she is ready for the sleepless nights and swollen feet of pregnancy to be over with. But those last few weeks are proving to be vitally important.
A typical pregnancy should last about 40 weeks. Babies who are born more than three weeks early are considered to be preterm and are known to have an increased risk for medical and developmental problems. In addition, preterm birth is associated with an increased risk for death in infancy and early childhood. While the impact of preterm delivery on infants and children has long been known, a new study published in JAMA suggests that the negative health impact of preterm delivery may reach into adulthood.
A team of researchers from Stanford University and Lund University in Sweden found that individuals who were born prematurely had an increased chance of dying during young adulthood.
The researchers reviewed records of 674,820 people who were born in Sweden between 1973 and 1979. Although 4,463 of these individuals passed away between the ages of 18 and 36, those who were born prior to 37 weeks gestation were more likely to have died as young adults than those who were delivered at full term. The death rate was almost twice as high for the extreme preterm group (delivered at 22-27 weeks gestation) compared to the full term group (37-42 weeks).
It is not fully understood how preterm delivery would increase the risk for death in early adulthood, especially since no increase in risk was found in late childhood or adolescence. Individuals in both the preterm and full term groups passed away due to neurological disorders, cancer, and injury. However, individuals in the preterm group were more likely to have died due to complications from congenital birth defects, respiratory disorders, endocrine disorders, and cardiovascular problems.
In the study population, only 5 percent of the individuals were preterm. However, the March of Dimes reports that in the United States in 2008, approximately 1 in 8 babies, or 12.3 percent of live births, were preterm. If preterm birth increases the risk for death not only in infancy and early childhood but also in young adulthood, our nation’s high preterm birth rate could have huge public health consequences.
Although the cause of preterm labor and delivery is not clearly understood, there are some known risk factors. According to the American Pregnancy Association, medical conditions such as recurring bladder and/or kidney infections, high blood pressure, diabetes, and clotting disorders can put women at increased risk for preterm labor. Women can reduce their risk of preterm labor by getting prenatal care and social support during pregnancy. Women can also avoid risk factors for preterm labor, such as smoking, drugs, alcohol, stress, and having pregnancies close together (less than six to nine months between pregnancies).
Sources
Crump C, Sundquist K, Sunquist J, Winkleby MA, “Gestational age at birth and mortality in young adulthood,” Pubmed.
“Preterm Birth Overview,” March of Dimes.
“Premature Labor,” American Pregnancy Association.