Aryeh D. Stein, Fernando C. Barros, Santosh K. Bhargava, Wei Hao, Bernardo L. Horta, Nanette Lee, Christopher W. Kuzawa, Reynaldo Martorell, Siddarth Ramji, Alan Stein, Linda Richter
Objective To assess the impact of being born preterm or small for gestational age (SGA) on several adult outcomes. Study design We analyzed data for 4518 adult participants in 5 birth cohorts from Brazil, Guatemala, India, the Philippines, and South Africa. Results In the study population, 12.8% of males and 11.9% of females were born preterm, and 26.8% of males and 22.4% of females were born term but SGA. Adults born preterm were 1.11 cm shorter (95% CI, 0.57-1.65 cm), and those born term but SGA were 2.35 cm shorter (95% CI, 1.93-2.77 cm) compared with those born at term and appropriate size for gestational age. Blood pressure and blood glucose level did not differ by birth category. Compared with those born term and at appropriate size for gestational age, schooling attainment was 0.44 years lower (95% CI, 0.17-0.71 years) in those born preterm and 0.41 years lower (95% CI, 0.20-0.62 years) in those born term but SGA. Conclusion Being born preterm or term but SGA is associated with persistent deficits in adult height and schooling, but is not related to blood pressure or blood glucose level in low- and middle-income settings. Increased postnatal growth is associated with gains in height and schooling regardless of birth status, but not with increases in blood pressure or blood glucose level. © 2013 Mosby Inc. All rights reserved.
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States; MRC/Wits Developmental Pathways for Health Research Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa; Postgraduate Program in Health and Behavior, Universidade Católica de Pelotas, Pelotas, Brazil; Department of Pediatrics, S. L. Jain Hospital, Delhi, India; Postgraduate Program in Epidemiology, Universidade Federal de Pelotas, Rio Grande do Sul, Brazil; Office of Population Studies Foundation, University of San Carlos, Cebu, Philippines; Department of Anthropology and Institute for Policy Research, Northwestern University, Evanston, IL, United States; Department of Pediatrics, Maulana Azad Medical College, New Delhi, India; Section of Child and Adolescent Psychiatry, University of Oxford, Oxford, United Kingdom; Human Sciences Research Council, Durban, South Africa
