Adults born extremely preterm may face a significantly higher risk of major depressive disorder and anxiety later in life, according to a new study published in eClinicalMedicine.
The research, led by Dr. Achim Fieß from the University Medical Center of the Johannes Gutenberg University Mainz, Germany, explored the long-term psychological impact of early birth and abnormal fetal growth.
While earlier studies have associated prematurity and low birth weight with mental health challenges in childhood and adolescence, this study examined how these early-life factors influence mental health well into adulthood. Researchers conducted a retrospective cohort analysis of 606 adults aged 18 to 52, born between 1969 and 2002. Participants were grouped based on gestational age: extremely preterm (≤28 weeks), very preterm (29–32 weeks), moderately preterm (33–36 weeks), and full-term (≥37 weeks).
Mental health outcomes—specifically major depressive disorder and anxiety—were assessed using the Patient Health Questionnaire. The analysis adjusted for age, gender, socioeconomic status, early childhood behavioral issues, and maternal alcohol and tobacco use during pregnancy.
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Key findings include:
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Adults born at or before 28 weeks were over four times more likely to develop major depressive disorder (OR = 4.14).
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They were more than five times as likely to be diagnosed with anxiety disorder (OR = 5.17) compared to full-term counterparts.
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Birth weight percentile—used to gauge fetal growth—did not significantly affect adult mental health outcomes.
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Early childhood emotional and peer-related problems (ages 2–4) were strongly associated with adult depression in those born preterm.
Notably, when maternal factors such as smoking and alcohol use during pregnancy were considered, the association between extreme prematurity and depression lost statistical significance. However, the link with anxiety disorder remained robust.
The study underscores that extreme prematurity, rather than low birth weight alone, is a critical factor in predicting adult mental health risks. It lends strong support to the Developmental Origins of Health and Disease (DOHaD) theory, which emphasizes the lasting impact of early life conditions on long-term health.
The authors stress the importance of ongoing mental health monitoring and support for individuals born extremely preterm, not just in childhood but throughout their lives. Early interventions, they note, could help reduce the long-term burden of depression and anxiety.
Source: Medical Dialogues
