Adults born very prematurely may have lower incomes, fewer sexual encounters

By early adulthood, adults who were born prematurely at low birth weights are less likely to be employed and to have children, and more likely to have lower incomes, be single and have chronic health conditions than those born at a healthy weight, according to a new study.

The new study continues to follow the first generation of extremely low birth weight babies who survived in the early era of advanced neonatal care, said lead author Dr. Saroj Saigal of McMaster University in Ontario. “We reported their outcomes a decade ago at 24 years of age and at that time they were comparable to (full-term) children, despite the fact that 28 percent had disabilities,” Saigal told Reuters Health by phone. “Employment and educational parameters were similar.”

But after the transition to adulthood, there are differences between the groups, she said. The researchers studied 189 adults born between 1977 and 1982. One hundred had been born prematurely, weighing less than 1 kg, while the other 89 had weighed more than 2.5 kg. All participants completed standardized questionnaires on health, education, employment, social integration, sexuality and reproduction.

More than half of each group were women. One in five of those born premature had neurologic impairments. In their mid-20s, the two groups had similar life circumstances and achievement, and at ages 29 to 36, educational achievement and family and partner relationships were still similar - but fewer premature adults were employed or employed full time.

On average, the premature group was making $20,000 less per year than the term group. Half of the premature group was never married or single, compared to about a third of the full-term group, and 20 percent had never experienced sexual intercourse compared to 2 percent of the term group, as reported in JAMA Pediatrics, May 23.

Neurological disabilities explain some of the differences, but personality differences also play a role, Saigal said. “Overall the majority were educated, living independently, employed, contributing to society,” but those born very premature tended not to be “go-getters” as much as those born at term, she said.

More adults in the premature group also reported being homosexual or bisexual than in the term group, although it’s not clear why that would be and the sample of people in this study was relatively small, she said. Most of the difference came from individuals in the low birth weight group identifying as bisexual, said Peter Anderson of Murdoch Children's Research Institute in Melbourne, Australia, who was not part of the new study.

The study “has provided enormous insights into our understanding of how these infants transition through childhood to adolescence to adulthood,” Anderson told Reuters Health by email. “The results are predominantly positive given their vulnerability at birth.”

“Hopefully children born today should do equally well if not better than children born earlier,” given advancements in neonatal care, Saigal said. “The majority of times we do not know why infants are born this early.”