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Whether this translates to increased risk of bone fractures is uncertain. We assessed fracture risk from childhood to early adulthood in relation to gestational age and sex by conducting a nationwide register-linkage cohort study comprising all 223\u2009615 liveborn (January 1987\u2013September 1990) singletons (9161, 4.1%; preterm) in Finland. Cox regression models provided hazard ratios (HRs) for fracture diagnosis in public specialty health care in both first and recurrent event settings during the whole follow-up (0\u201329\u00a0years) and during different age periods (0\u20134, 5\u20139, 10\u201329\u00a0years). Gestational age was considered categorical (full-term, 39\u201341\u00a0weeks; reference). A total of 39\u2009223 (17.5%) children or young adults had at least 1 fracture. In analyses not stratified by sex, only extremely preterm birth (&amp;lt;28 completed weeks\u2019 gestation) was associated with risk of bone fracture at 0\u201329\u00a0years (adjusted HR [aHR]: 0.46; 95% CI: 0.28\u20130.74) compared with those born full-term. Among females, gestational age was unrelated to fracture risk at 0\u201329\u00a0years. Among males, extremely and very preterm (28\u201331\u00a0weeks) birth was associated with lower risk of fracture at 0\u201329\u00a0years compared with those born full-term (aHR: 0.38 [95% CI: 0.21\u20130.71] and 0.75 [95% CI: 0.59\u20130.95], respectively). Restricting the analyses to the individuals without severe medical condition(s) attenuated the associations. However, the fracture risk varied according age and sex: at 10\u201329\u00a0years, moderately preterm (32\u201333 weeks) females and extremely and very preterm males had a lower risk (aHR: 0.63 [0.43\u20130.94], 0.35 [0.17\u20130.69], and 0.74 [0.57\u20130.95], respectively), while late-preterm birth (34\u201336 weeks) was associated with a 1.6-fold higher risk among females at 0\u20135\u00a0years, and a 1.4-fold risk among males at 5\u201310\u00a0years. Analyses on recurrent fractures showed a similar pattern. Children and young adults, in particular males, born extremely or very preterm may have fewer bone fractures; this is partly explained by severe medical conditions in this group.<\/jats:p>","DOI":"10.1093\/jbmr\/zjaf011","type":"journal-article","created":{"date-parts":[[2025,1,23]],"date-time":"2025-01-23T01:56:01Z","timestamp":1737597361000},"page":"382-395","source":"Crossref","is-referenced-by-count":3,"title":["Preterm birth and risk of bone fractures during childhood and early adulthood"],"prefix":"10.1093","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4010-5299","authenticated-orcid":false,"given":"Suvi","family":"Alenius","sequence":"first","affiliation":[{"name":"Finnish Institute for Health and Welfare , Helsinki and Oulu , FIN-00271,","place":["Finland"]},{"name":"Children's Hospital, University of Helsinki and Helsinki University Hospital , Helsinki , FIN-00014,","place":["Finland"]},{"name":"Faculty of Medicine, Research Unit of Clinical Medicine, MRC Oulu, Oulu University Hospital and University of Oulu , Oulu , FIN-90014,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maija E","family":"Miettinen","sequence":"additional","affiliation":[{"name":"Finnish Institute for Health and Welfare , Helsinki and Oulu , FIN-00271,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markku","family":"Nurhonen","sequence":"additional","affiliation":[{"name":"Finnish Institute for Health and Welfare , Helsinki and Oulu , FIN-00271,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuli","family":"Salmi","sequence":"additional","affiliation":[{"name":"FVR\u2014Finnish Vaccine Research , Tampere , FIN-33100,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieta","family":"N\u00e4s\u00e4nen-Gilmore","sequence":"additional","affiliation":[{"name":"Finnish Institute for Health and Welfare , Helsinki and Oulu , FIN-00271,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peija","family":"Haaramo","sequence":"additional","affiliation":[{"name":"Finnish Institute for Health and Welfare , Helsinki and Oulu , FIN-00271,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjaana","family":"Tikanm\u00e4ki","sequence":"additional","affiliation":[{"name":"Finnish Institute for Health and Welfare , Helsinki and Oulu , FIN-00271,","place":["Finland"]},{"name":"Faculty of Medicine, Research Unit of Clinical Medicine, MRC Oulu, Oulu University Hospital and University of Oulu , Oulu , FIN-90014,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marja","family":"V\u00e4\u00e4r\u00e4sm\u00e4ki","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Research Unit of Clinical Medicine, MRC Oulu, Oulu University Hospital and University of Oulu , Oulu , FIN-90014,","place":["Finland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[{"name":"Finnish Institute for Health and Welfare , Helsinki and Oulu , FIN-00271,","place":["Finland"]},{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm , SE-17177,","place":["Sweden"]},{"name":"Academic Primary Health Care Centre, Region Stockholm , Stockholm , SE-10431,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4547-001X","authenticated-orcid":false,"given":"Outi","family":"M\u00e4kitie","sequence":"additional","affiliation":[{"name":"Children's Hospital, University of Helsinki and Helsinki University Hospital , Helsinki , FIN-00014,","place":["Finland"]},{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm , SE-17177,","place":["Sweden"]},{"name":"Folkh\u00e4lsan Institute of 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