Due to dramatic improvements in perinatal and neonatal care in most industrialized countries over the past few decades, more than 95% of infants born before 37 weeks of gestation survive. These “preterm” infants constitute about 10% of the adult population. Recent research has shown that this cohort is at a higher risk for developing a range of adverse medical and social problems, such as hypertension, cardiovascular, cerebrovascular, and kidney disorders, diabetes and metabolic syndrome, and neuro-psychiatric and behavioral problems. Yet, these issues have not been widely appreciated by healthcare professionals caring for these adult patients.
Because even a modest increase (e.g., 10-20%) in risk for these chronic conditions can translate into a substantial population burden, the U.S. National Institutes of Health convened a conference of multi-disciplinary experts in August 2015 with the objective of elucidating the epidemiological, public health and societal burden of diseases among adults born preterm, while reviewing potential mechanisms and proposing educational and research priorities.
There is an urgent need to inform healthcare providers about adult outcomes for those born preterm. Low gestational age at birth, birth weight and the duration of initial hospitalization should trigger an alert to seek additional information such as major complications and long-term medication use. Obtaining birth and neonatal health history should be considered when assessing all adult patients seeking medical care, such that potential preventive steps can be implemented. The initial hospital discharge summary can be useful while assessing potential risks of “adult” diseases among such individuals. Increased availability of electronic medical records may render such efforts possible.
An organ-specific research agenda provides a strategy to better understand the mechanistic underpinnings of poor adult outcomes, and the factors that mitigate them. Insights from such studies can also help optimize neonatal care so that the burden of disease during adulthood among those born preterm can be reduced or ameliorated.
Research Agenda: Pulmonary
Research Agenda: Cardiovascular and Metabolic