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Invited Commentary
July 12, 2019

Social Relationships, Preterm Birth or Low Birth Weight, and the Brain

Author Affiliations
  • 1Centre for the Developing Brain, Department of Perinatal Imaging and Health, Division of Imaging Sciences and Biomedical Engineering, King’s College London, London, United Kingdom
  • 2Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
JAMA Netw Open. 2019;2(7):e196960. doi:10.1001/jamanetworkopen.2019.6960

Survival of individuals who are born preterm or with low birth weight has increased owing to significant breakthroughs in neonatal intensive care practices that occurred in the 1970s and 1980s, antenatal corticosteroids, surfactant therapy, and high-frequency ventilation. As a result, a generation of infants born preterm or with low birth weight has now reached adulthood. The study by Mendonça et al1 contributes to increasing the current understanding of the long-term sequelae of preterm birth or low birth weight by presenting a meta-analysis of the literature that investigates the association of preterm birth or low birth weight with social outcomes in adulthood, including the establishment and quality of romantic relationships, sexual activity, parenthood, and peer social support.1 Among the more than 4 million participants included in the studies analyzed by Mendonça et al,1 adults who were born preterm or with low birth weight were less likely than the control groups to be involved in romantic partnerships, showed decreased engagement in sexual activity, and were less likely to become parents. All these factors could contribute to overall poorer well-being and mental health. Results of the meta-analysis by Mendonça et al1 highlight a gradient risk of severity associated with gestational age, with individuals who were born extremely preterm (<28 weeks) or with extremely low birth weight (<1000 grams) representing the most likely subgroup to have worse social outcomes. However, encouragingly, the data suggest that the reported quality of relationships with partners and friends did not differ between adults who were born preterm or with low birth weight and their peers who were born at term.

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