The Journal of pediatrics · 2026
Middle Childhood Morbidity in Children Born Preterm: A Canadian Cohort Study.
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Ali Sumera Aziz, Shen Ye, Bone Jeffrey N, Richter Lindsay L, Lisonkova Sarka, Gette Faith, Kieran Emily, Chan Edmond S, Mammen Cherry, Lam Carol, Roberts Ashley, Kang Kristopher T, Rumsey Dax G, McGrath Tara, Harris Kevin C, Yang Connie L, Wong Jonathan, Chan Natalie H, Lee James, Rassekh Shahrad R, Chan Anthony K C, Ting Joseph Y
Аннотация
OBJECTIVE: To assess the risk of middle-childhood (ages 5-10 years) morbidities among children born preterm.
STUDY DESIGN: We conducted a population-based cohort study of children born in British Columbia, Canada (2004-2017), followed from ages 5 to 10 years. Gestational age was categorized as 22-28, 29-33, 34-36, 37-41 (reference), and 42-44 weeks. Morbidity outcomes were allergic, cardiac, dermatologic, endocrine, hematologic, renal, neurologic, oncologic, respiratory, rheumatologic, and sleep. Cox proportional hazard models were used to compute adjusted hazard ratios (aHRs) and 95% CIs.
RESULTS: In the cohort of 510 424 children, 9.50% were born preterm. Morbidity rates ranged from <1.0% (eg, cardiac, gastrointestinal, epilepsy, and oncologic disorders) to 16.37% (allergic), with greater rates among children born preterm than at term. A dose-response relationship was observed for several outcomes, with risks increasing as gestational age decreased. For puberty and disorders of sexual development, aHRs (95% CIs) were 2.17 (1.51-3.11), 1.99 (1.67-2.37), and 1.28 (1.14-1.43) among children born at 22-28, 29-33, and 34-36 weeks, respectively. Corresponding aHRs (95% CIs) for cardiac conditions were 4.20 (2.87-6.14), 1.90 (1.47-2.45), and 1.51 (1.30-1.75); for neurologic conditions were 3.20 (2.96-3.46), 1.54 (1.47-1.61), and 1.27 (1.23-1.30); and for respiratory conditions were 2.55 (2.33-2.78), 1.52 (1.45-1.60), and 1.23 (1.19-1.26), respectively.
CONCLUSIONS: Children born preterm show elevated morbidity risks at ages 5-10 years. Risks increased with decreasing gestational age, reinforcing the need for ongoing monitoring and interventions to reduce long-term health complications.
STUDY DESIGN: We conducted a population-based cohort study of children born in British Columbia, Canada (2004-2017), followed from ages 5 to 10 years. Gestational age was categorized as 22-28, 29-33, 34-36, 37-41 (reference), and 42-44 weeks. Morbidity outcomes were allergic, cardiac, dermatologic, endocrine, hematologic, renal, neurologic, oncologic, respiratory, rheumatologic, and sleep. Cox proportional hazard models were used to compute adjusted hazard ratios (aHRs) and 95% CIs.
RESULTS: In the cohort of 510 424 children, 9.50% were born preterm. Morbidity rates ranged from <1.0% (eg, cardiac, gastrointestinal, epilepsy, and oncologic disorders) to 16.37% (allergic), with greater rates among children born preterm than at term. A dose-response relationship was observed for several outcomes, with risks increasing as gestational age decreased. For puberty and disorders of sexual development, aHRs (95% CIs) were 2.17 (1.51-3.11), 1.99 (1.67-2.37), and 1.28 (1.14-1.43) among children born at 22-28, 29-33, and 34-36 weeks, respectively. Corresponding aHRs (95% CIs) for cardiac conditions were 4.20 (2.87-6.14), 1.90 (1.47-2.45), and 1.51 (1.30-1.75); for neurologic conditions were 3.20 (2.96-3.46), 1.54 (1.47-1.61), and 1.27 (1.23-1.30); and for respiratory conditions were 2.55 (2.33-2.78), 1.52 (1.45-1.60), and 1.23 (1.19-1.26), respectively.
CONCLUSIONS: Children born preterm show elevated morbidity risks at ages 5-10 years. Risks increased with decreasing gestational age, reinforcing the need for ongoing monitoring and interventions to reduce long-term health complications.