Emerging research from the University of Rhode Island College of Nursing has shed new light on the far-reaching impacts of preterm birth, establishing it not merely as a neonatal concern but as a chronic condition with lifelong health consequences. This landmark study, led by Associate Professor Amy D’Agata, is the longest continuously running investigation of individuals born preterm in the United States, meticulously tracking a cohort of 215 individuals over 35 years. The findings compellingly suggest that the stresses endured by infants born prematurely extend well beyond infancy, influencing both physical and psychological health throughout the lifespan.
Initiated in the 1980s at Women & Infants Hospital, the study contrasts individuals born between 22 and 36 weeks gestation with a control group of full-term peers, providing a rich longitudinal dataset grounded in rigorous clinical follow-up. The cohort, now approaching middle age, reveals a distinct pattern of chronic health vulnerabilities linked to early birth. These include elevated risks for hypertension, dyslipidemia, increased visceral adiposity, and osteopenia. Such physiological markers are critical because they predicate chronic diseases that manifest more commonly in later adulthood, thereby necessitating a lifetime perspective on preterm birth outcomes.
D’Agata’s team recently published these latest findings in JAMA Network Open, focusing particularly on health trajectories as the cohort reaches 35 years of age. The data unmask a troubling association between preterm birth and persistent internalizing psychological issues, namely elevated rates of depression and anxiety disorders. The intersection of physical and mental health challenges underscores a multifaceted impact of early birth stressors that standard pediatric follow-ups have yet to fully address.
A crucial insight emerging from the study is the pervasive neglect of birth history in adult medical records. Despite millions of individuals born preterm now regularly accessing adult healthcare services, birth circumstances are seldom recorded or considered during clinical evaluations. The absence of this fundamental information hampers clinicians’ ability to identify at-risk patients, precluding tailored screening and intervention strategies that could mitigate long-term health risks.
Professor D’Agata advocates for systemic changes in healthcare protocols, urging the integration of birth history as a standard inquiry in adult medical intake forms. This shift could transform clinical practice by enabling earlier identification of preterm-born adults who require targeted monitoring and preventive care. Such measures hold promise not only to reduce the burden of chronic illnesses but also to enhance health equity by recognizing a medically underserved population often overlooked by conventional paradigms.
The research emphasizes the importance of conceptualizing preterm birth as a chronic developmental condition rather than an isolated neonatal event. This re-framing helps elucidate the biological mechanisms that link early life adversity to adult disease expression. Understanding these pathways is vital as it may unlock novel preventive and therapeutic avenues, ultimately improving quality of life for survivors of preterm birth.
Looking ahead, D’Agata and her collaborators are delving into the realm of epigenetics to further decode the enduring legacy of prematurity. Their ongoing investigations into epigenetic age acceleration aim to discern whether individuals born preterm exhibit markers of accelerated biological aging compared to their full-term counterparts. Epigenetic modifications, which regulate gene expression without altering DNA sequences, might provide mechanistic insights into how early developmental stress translates into premature onset of age-related diseases.
The preliminary exploration into epigenetic patterns complements the physiological and psychological data, painting an integrated portrait of preterm birth as a multifactorial determinant of lifelong health trajectories. Such a holistic approach represents a crucial advance in personalized medicine and underscores the value of longitudinal cohort studies in capturing the evolution of chronic conditions over decades.
Beyond the scientific community, the findings carry significant implications for public health policy and patient advocacy. By illuminating the chronic health challenges linked to prematurity, the study reinforces the need for comprehensive support systems that extend well beyond infancy into adulthood. Mental health services, chronic disease management, and preventive care frameworks must all adapt to incorporate knowledge of preterm birth history to truly optimize outcomes.
This research also highlights the critical role of funding in sustaining longitudinal studies that bridge gaps between neonatal care and adult health. With over $10 million invested since its inception, the study exemplifies the impact of sustained financial support for long-term population health research, informing evidence-based policy and guiding clinical innovations.
Ultimately, the University of Rhode Island study invites a paradigm shift in how healthcare systems view and manage preterm birth survivors. The integration of birth history into adult healthcare records, combined with targeted screening and an understanding of underlying biological mechanisms, offers the potential to substantially reduce morbidity and improve life quality for millions. Recognizing preterm birth as a chronic, lifelong condition is a clarion call for clinicians, researchers, and policymakers alike to unite in crafting a future where early birth history guides comprehensive, equitable care.
Subject of Research: The lifelong psychological and physiological health outcomes associated with preterm birth.
Article Title: ‘Psychological and Physical Health of a Preterm Birth Cohort at Age 35 Years’
News Publication Date: 22-Jul-2025
Web References:
References:
D’Agata, A. et al. Psychological and Physical Health of a Preterm Birth Cohort at Age 35 Years. JAMA Network Open, 2025. DOI: 10.1001/jamanetworkopen.2025.22599
Image Credits: Patrick Luce
Keywords: Premature birth, preterm birth, lifelong health, chronic condition, epigenetics, psychological health, physical health, birth history, adult medical records, longitudinal cohort study
