{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T19:34:30Z","timestamp":1792870470623,"version":"4.5.0"},"reference-count":59,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>The US\u2019s longest-running preterm birth cohort study is nearing its 40th anniversary. With rising survival rates for preterm birth, understanding adult health outcomes is essential; early life medical risk trajectories are hypothesized to lead to poorer outcomes by age 35 years.<\/jats:p><\/jats:sec>Objective<\/jats:title>To examine how early life medical risk is associated with psychological and physiological health in adulthood, highlighting the supportive roles of social protection and childhood socioeconomic status (SES).<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cohort study included data from a longitudinal follow-up of a cohort from a level III neonatal intensive care unit in New England between 1985 and 1989, along with a control group of healthy full-term infants. Data were collected from March 2020 to March 2024 for the tenth follow-up using a longitudinal cohort approach. Inclusion criteria targeted preterm infants weighing under 1850 g with various neonatal diagnoses. Critically ill infants with low survival or major congenital anomalies were excluded. Biospecimens, physiological measurements, and imaging data were collected at a single clinical facility, while self-report surveys were gathered at home.<\/jats:p><\/jats:sec>Exposure<\/jats:title>Early life medical risk from preterm birth.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Primary outcomes included psychological and physiological health. Adult self-report questionnaire, blood pressure, cholesterol levels, triglycerides, glucose, glycosylated hemoglobin, insulin resistance, and dual-energy x-ray absorptiometry scan were measured. Statistical analyses included latent growth curve and path models using the medical risk index, social protection index, and SES.<\/jats:p><\/jats:sec>Results<\/jats:title>The study sample included 158 preterm and 55 full-term\u2013born adults (mean [SD] age, 35.0 [1.3] years; 107 [50.2%] female). Higher medical risk severity was associated with increases in internalizing problems (\u03b2 [SE], 0.85 [0.33]; P<\/jats:italic>\u2009=\u2009.01), higher systolic blood pressure (\u03b2 [SE], 7.15 [2.47]; P<\/jats:italic>\u2009=\u2009.004), lower high-density lipoprotein cholesterol (\u03b2 [SE], \u221213.07 [4.4]; P<\/jats:italic>\u2009=\u2009.003), higher triglycerides (\u03b2 [SE], 53.97 [24.6]; P<\/jats:italic>\u2009=\u2009.03), higher android-to-gynoid fat ratio (\u03b2 [SE], 0.22 [0.08]; P<\/jats:italic>\u2009=\u2009.006), and lower bone density (\u03b2 [SE], \u22121.14 [0.40]; P<\/jats:italic>\u2009=\u2009.004).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cohort study, preterm individuals had higher early life medical risk and faced increased mental health disorders, cardiometabolic issues, and body composition differences compared with full-term peers at age 35 years. Despite strong evidence linking preterm birth to long-term health consequences, many primary care clinicians in the US remain unaware of these risks, often due to infrequent birth history inquiries in adult health care settings.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.22599","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T15:00:32Z","timestamp":1753196432000},"page":"e2522599","source":"Crossref","is-referenced-by-count":13,"title":["Psychological and Physical Health of a Preterm Birth Cohort at Age 35 Years"],"prefix":"10.1001","volume":"8","author":[{"given":"Amy L.","family":"D\u2019Agata","sequence":"first","affiliation":[{"name":"College of Nursing, University of Rhode Island, Kingston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Eaton","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode 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