Remarkable progress has taken place in neonatal intensive care during the recent decades. This has facilitated the survival of more and more prematurely born infants. The first infants that have been treated in modern neonatal intensive care are now entering adulthood.
Under the recent years it has become increasingly clear that circumstances and growth during the fetal period and childhood affect an individual’s length during the entire life course. In addition to the HeSVA project, our team assesses these questions in the
Idefix study.
Early growth and health in later life
Slow fetal growth in term pregnancy is well known to be associated with cardiovascular diseases and their risk factors including blood pressure and glucose and lipid metabolism. It would be important to know whether preterm birth is associated with similar risks in adult life, because these risks can be substantially reduced by e.g. a healthy lifestyle. It is also of note that not all long-term consequences are harmful. For example, children born severely preterm have been found to have less often allergy than their term-born peers.
There are 338 young adults born during 1978-1985 participating in the Helsinki Preterm Adults’ Study. Of them, 166 have been born with very low birth weight (below 1500 g) and been treated at the Neonatal Intensive Care Unit at Children’s Hospital at Helsinki University Central Hospital, and 172 have been born at term. The participants have undergone detailed evaluations of cardiovascular system, glucose metabolism, sleep and bone health.
We are also in particular interested in the effect of preterm birth on psychological factors during adult life, such as individual differences in personality characteristics and physiological responsiveness to stressful situations that may occur in daily life. We are also in general interested in the life situation of very low birth weight born subjects as young adults – study, choice of career, intimate relationships and starting a family – of which not much is thus far known.
The results from the first phase of the study are currently being analysed. The project will be continued based on questions raised by the results arising from the first phase.
We have found that young adults born preterm with very low birth weight have on average a higher degree of impaired glucose regulation and higher blood pressure than young adults who were born at term. These findings may indicate an increased risk of cardiovascular disease and type 2 diabetes later during the life course. Such risks can, however, be effectively reduced by healthy lifestyle (including physical activity and diet).
We have in addition shown that young adults with very low birth weight have on average less depressive symptoms than those who were born at term. However, those very low birth weight adults whose birth weight was low in relation to duration of gestation had a higher degree of depressive symptoms than expected. Furthermore, young adults with very low birth weight differ on average from those born at term in their personality characteristics: very low birth weight adults are more dutiful and cautious and display more warmth in their personal relationships. We emphasise the words “on average”: there are considerable differences between individuals, and the development of personality is affected by a large number of factors. In ongoing studies our aim is to find out how much these differences are explained by possible differences in parenting and whether they are also affected by biological mechanisms related to preterm birth.
The contact person of the project is Adjunct Professor Eero Kajantie.