Socioeconomic outcomes in very preterm/very low birth weight adults: individual participant data meta-analysis
Zhou, Yanlin; Mendonça, Marina; Tsalacopoulos, Nicole; Bartmann, Peter; Darlow, Brian A; Harris, Sarah L; Horwood, John; Woodward, Lianne J; Anderson, Peter J; Doyle, Lex W; Cheong, Jeanie L Y; Kajantie, Eero; Tikanmäki, Marjaana; Johnson, Samantha; Marlow, Neil; Nosarti, Chiara; Indredavik, Marit S; Evensen, Kari Anne I; Räikkönen, Katri; Heinonen, Kati; van der Pal, Sylvia; Wolke, Dieter (2025-05-03)
Springer
03.05.2025
Zhou, Y., Mendonça, M., Tsalacopoulos, N. et al. Socioeconomic outcomes in very preterm/very low birth weight adults: individual participant data meta-analysis. Pediatr Res (2025). https://doi.org/10.1038/s41390-025-04082-1
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https://creativecommons.org/licenses/by/4.0/
© The Author(s) 2025. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
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Julkaisun pysyvä osoite on
https://urn.fi/URN:NBN:fi:oulu-202505053071
https://urn.fi/URN:NBN:fi:oulu-202505053071
Tiivistelmä
Abstract
Background:
Very preterm (VPT; <32 weeks) or very low birth weight (VLBW; <1500 g) birth is associated with socioeconomic disadvantages in adulthood; however, the predictors of these outcomes remain underexplored. This study examined socioeconomic disparities and identified neonatal and sociodemographic risk factors among VPT/VLBW individuals.
Methods:
A one-stage individual participant data meta-analysis was conducted using 11 birth cohorts from eight countries, comprising 1695 VPT/VLBW and 1620 term-born adults aged 18–30 years.
Results:
VPT/VLBW adults had lower odds of higher educational attainment (0.40[0.26–0.59]), remaining in education (0.63[0.47–0.84]) or paid work (0.76[0.59–0.97]), and higher odds of receiving social benefits (3.93[2.63–5.68]) than term-borns. Disparities in education and social benefits persisted after adjusting for age, sex, and maternal education, even among those without neurosensory impairments (NSI). Among VPT/VLBW adults, NSI significantly impacted all socioeconomic outcomes, increasing the odds of receiving social benefits 6.7-fold. Additional risk factors included medical complications, lower gestational age and birth weight, lower maternal education, younger maternal age, and non-white ethnicity.
Conclusions:
NSI is the strongest risk factor for adulthood socioeconomic challenges in the VPT/VLBW population. Mitigating these disparities may require improved neonatal care to reduce NSI prevalence and targeted social and educational support for VPT/VLBW individuals.
Impact:
Very preterm or very low birth weight (VPT/VLBW) birth is associated with socioeconomic disadvantages in adulthood, including lower educational attainment, lower employment rates, and a higher need for social benefits compared with individuals born at term.
Neurosensory impairments are strongly associated with adverse socioeconomic outcomes among VPT/VLBW adults, while lower gestational age, lower birth weight, and sociodemographic disadvantages serve as additional risk factors.
Early interventions in the NICU that reduce medical complications, along with enhanced educational support throughout childhood, may help mitigate long-term socioeconomic disparities for individuals born VPT/VLBW.
Background:
Very preterm (VPT; <32 weeks) or very low birth weight (VLBW; <1500 g) birth is associated with socioeconomic disadvantages in adulthood; however, the predictors of these outcomes remain underexplored. This study examined socioeconomic disparities and identified neonatal and sociodemographic risk factors among VPT/VLBW individuals.
Methods:
A one-stage individual participant data meta-analysis was conducted using 11 birth cohorts from eight countries, comprising 1695 VPT/VLBW and 1620 term-born adults aged 18–30 years.
Results:
VPT/VLBW adults had lower odds of higher educational attainment (0.40[0.26–0.59]), remaining in education (0.63[0.47–0.84]) or paid work (0.76[0.59–0.97]), and higher odds of receiving social benefits (3.93[2.63–5.68]) than term-borns. Disparities in education and social benefits persisted after adjusting for age, sex, and maternal education, even among those without neurosensory impairments (NSI). Among VPT/VLBW adults, NSI significantly impacted all socioeconomic outcomes, increasing the odds of receiving social benefits 6.7-fold. Additional risk factors included medical complications, lower gestational age and birth weight, lower maternal education, younger maternal age, and non-white ethnicity.
Conclusions:
NSI is the strongest risk factor for adulthood socioeconomic challenges in the VPT/VLBW population. Mitigating these disparities may require improved neonatal care to reduce NSI prevalence and targeted social and educational support for VPT/VLBW individuals.
Impact:
Very preterm or very low birth weight (VPT/VLBW) birth is associated with socioeconomic disadvantages in adulthood, including lower educational attainment, lower employment rates, and a higher need for social benefits compared with individuals born at term.
Neurosensory impairments are strongly associated with adverse socioeconomic outcomes among VPT/VLBW adults, while lower gestational age, lower birth weight, and sociodemographic disadvantages serve as additional risk factors.
Early interventions in the NICU that reduce medical complications, along with enhanced educational support throughout childhood, may help mitigate long-term socioeconomic disparities for individuals born VPT/VLBW.
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