Late childhood and adolescent health outcomes in preterm-born infants during 2004-2012: a population-based cohort study in British Columbia, Canada.

Abstract

Despite improvements in newborn care, preterm birth remains linked to long-term adverse health outcomes. This study examines health outcomes among children and adolescents (10-17 years) born preterm and surviving to age 10 years. Utilizing perinatal and health registries of British Columbia, we included individuals born between 2004 and 2012 at 22-44 weeks' gestation who survived to age 10 years, with follow-up until 2022. Health outcomes were identified via outpatient and inpatient diagnostic codes. Cox proportional hazards models estimated adjusted hazard ratios (aHRs) with 95% confidence intervals (CI). Among 297,477 individuals, 6082 (2.0%) were born at 22-33 weeks' gestational age, 21,396 (7.2%) at 34-36 weeks, and 269,999 (90.8%) were at 37-44 weeks. Individuals born at 22-33 vs. 37-44 weeks had elevated risks of growth disorders (aHR 2.12, 95% CI 1.18-3.82) and vitamin D deficiency (aHR 1.38, 95% CI 1.05-1.80). Risks for cardiac (aHR 1.50, 95% CI 1.26-1.79), renal (aHR 1.25, 95% CI 1.13-1.39), and sleep disorders (aHR 1.30, 95% CI 1.12-1.50) were higher in individuals born at 34-36 vs. 37-44 weeks GA. Risks for hypothyroidism, neurological, respiratory, puberty, and sexual development disorders increased with decreasing gestational age. Children and adolescents born preterm who survived to age 10 years remain at increased risk of developing adverse health outcomes, emphasizing the necessity for targeted healthcare interventions to reduce long-term morbidity. British Columbia Women's Health Research Institute (2019), Canadian Institute of Health Research (2022), and Women and Children's Health Research Institute (2021-2026).