Transition to Adulthood for Extremely Preterm Survivors

Abstract

OBJECTIVE To compare transition into adulthood of survivors born extremely preterm (EP; <28 weeks’ gestation) or extremely low birth weight (ELBW; <1000 g) in the postsurfactant era with term-born controls. METHODS Prospective longitudinal cohort study of all EP/ELBW survivors born in the State of Victoria, Australia between January 1, 1991 and December 31, 1992 and matched term-born controls. Outcomes include educational attainment, employment, financial status, romantic partnering, living arrangements, parenthood, physical health and mental health, risk-taking behaviors, life satisfaction, and interpersonal relationships at 25 years. RESULTS Data were available from 165 EP/ELBW and 127 control participants. Overall, there was little evidence for differences between the EP/ELBW and control groups on most comparisons after adjustment for social risk and multiple births. However, compared with controls, the EP/ELBW group was more likely to have their main source of income from government (adjusted odds ratio [aOR] 2.49, 95% confidence interval [CI] 1.21–5.13; P = .01) and to have never moved out of the parental home (aOR 2.13, 95% CI 1.27–3.58; P = .01), and fewer had ever engaged in smoking (aOR 0.52, 95% CI 0.28–0.98; P = .04), binge drinking (aOR 0.41, 95% CI 0.18–0.93; P = .03), or street drugs (aOR 0.56, 95% CI 0.32–0.98; P = .04). CONCLUSIONS Aside from clinically important differences in main income source, leaving the parental home, and reduced risk-taking behavior, survivors born EP/ELBW in the era since surfactant was introduced are transitioning into adulthood similarly to term-born controls in some areas assessed but not all.