Study highlights long-term socioeconomic effects of preterm birth

By analyzing all live births in Canada over a six-year period and following children for more than two decades, researchers found that preterm births and the related cognitive, development and physical health impacts of prematurity are associated with lower income, employment and university enrollment.

Individuals born before 37 weeks of gestation, considered to be preterm infants, have, on average, lower employment income, university enrollment and educational attainment through age 28, according to a new study publishing November 6, 2024 in the open-access journal PLOS ONE by Petros Pechlivanoglou of The Hospital for Sick Children, Toronto, Canada.

Preterm birth affects about 10% of all births worldwide and accounts for 1 in 5 deaths in children. Economic and lifestyle factors can affect a family's access to therapies and supports, financial stability and quality of life.

Many studies have looked at the short-term clinical outcomes of preterm birth but few have followed these children over long time periods to also examine the socioeconomic impacts of preterm birth.

In the new study, Pechlivanoglou and colleagues used data on 2.4 million individuals born in Canada between 1990 and 1996. Information on the individuals' birth, as well as their employment and education through 2018 was available.

The study found that, after controlling for baseline characteristics such as parental demographics, the average income of preterm-born individuals at ages 18 to 28 was $958 CAD (6%) lower per year than those born at term. Those born preterm were also 2.13% less likely to be employed, 17% less likely to enroll in university, and 16% less likely to graduate with a university degree. For individuals born at the earliest gestation, 24-27 weeks, those associations were even stronger with a $5,463 CAD (17%) lower annual income and a 45% decrease in rates of university enrollment and graduation.

While clinical care during the neonatal period is critical, our findings suggest that the development of long-term supports (including psychological, education and vocational resources) that go beyond clinical care may help mitigate the longer-term effects of preterm birth. Policymakers and society as a whole must recognize that the socioeconomic impact of preterm birth may extend into early adulthood and that considerations for ongoing support could be vital to ensuring this population has equal opportunity to thrive."

Petros Pechlivanoglou, The Hospital for Sick Children, Toronto, ON, Canada