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Preterm birth linked to high blood pressure and anxiety in adults
Last reviewed: 03.08.2025
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The University of Rhode Island led a cohort study linking the premature cumulative medical risk index from birth to age 12 to adult disease at age 35.
Preterm birth affects about one in ten newborns in the United States each year, and survival rates have improved significantly since the 1980s. In the United States, birth history is rarely considered in adult care, and most of the known data on long-term outcomes for people born preterm come from international cohorts.
In the study, “Psychological and Physical Health of a Preterm Birth Cohort at Age 35 Years,” published in JAMA Network Open, researchers designed a prospective, longitudinal cohort study to examine how early-life medical risk influences psychological and physiological outcomes in adulthood.
A total of 213 individuals, initially recruited from a Level III neonatal intensive care unit in New England between 1985 and 1989, were followed through 2024. The sample included 158 adults born preterm (
Medical risk was calculated from birth to 12 years using a composite index including birth weight, gestational age, duration of oxygen therapy, and neurological and medical status at multiple time points. Health outcomes at 35 years included blood pressure, lipid levels, body composition by DEXA scan, and psychological status measured by the ASEBA Adult Self-Report.
Each one-point increase in early medical risk was associated with a 7 mmHg increase in systolic blood pressure, a 13 mg/dL decrease in HDL cholesterol, and a 54 mg/dL increase in triglycerides. Fat was more likely to accumulate in the abdomen than in the lower body, and bone mineral density was lower. Internal psychological problems, such as anxiety and depression, also increased with higher early risk.
No associations were found for diastolic blood pressure, LDL cholesterol, glycated hemoglobin A1c, or inflammatory markers. Childhood socioeconomic status and social protection did not significantly modify these outcomes, although higher SES was associated with lower IL-6 levels.
The researchers conclude that preterm birth and the severity of early medical complications are associated with lifelong health consequences, including mental health and cardiometabolic vulnerabilities.
Without clinical guidelines for screening adults born preterm, many clinicians may miss risk factors that originate early in life. As the preterm population ages, long-term monitoring and individualized preventive care can help meet the needs of this growing group.