The longest-running preterm birth cohort study in the US has found that adults who were born preterm can be at higher risk of conditions that affect physical and mental health well into their 30s, researchers have reported in JAMA Network Open.
The RHODE – or Rhode Island Cohort of Adults Born Preterm – Study began in the 1980s and has followed 215 people – most of whom were born preterm – as they grew into adulthood.
“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,” the study team wrote.
Amy D’Agata, a professor at the University of Rhode Island College of Nursing who became principal researcher for the RHODE Study in 2022, shares insights about the study, the importance of considering birth history as part of a patient’s broader medical history and what inspires her research.
What interests led you to a career as a nurse scientist?
D’Agata: My career began at the bedside in the NICU, where I saw firsthand both the fragility and resilience of preterm infants and their families. Over time, I became increasingly curious about what happened to these children as they grew older. I noticed these types of questions that weren’t being asked in daily clinical care. That curiosity, combined with my commitment to improving lifelong outcomes, pushed me toward research.
My doctoral and postdoctoral work deepened my understanding of early life stress, physiology, and development, and I realized that answering these questions required long-term, interdisciplinary studies. Becoming a nurse scientist allowed me to merge my clinical experience, my interest in complex biological and social systems, and my drive to generate evidence that can truly change care across the life span.
What would you like clinicians to understand about your study and what it says about incorporating birth history into a patient’s medical history?
D’Agata: One of the most important takeaways is that preterm birth is not just a neonatal event; preterm birth has lifelong health implications. Our study shows that adults born preterm, especially those with higher medical risk in infancy, are more likely to face mental health challenges, cardiometabolic differences, and lower bone density by their mid-30s. These risks are often invisible in primary care because most clinicians don’t ask about birth history in adult visits. By incorporating birth history into every patient intake, clinicians can identify individuals at higher risk for chronic conditions that may occur earlier in life, tailor screening and prevention strategies, and address needs that might otherwise be missed.
What would you like people to understand better about their children’s and their own birth history?
D’Agata: Your birth history is a vital part of your health story, just like your family history or lifestyle factors. For individuals born preterm, it can shape long-term health in ways that aren’t always obvious early on.
I would like people, whether they are parents of young children or adults reflecting on their own birth, to recognize that knowing and sharing this information with health care providers can make a difference. It can help guide proactive care, inform appropriate screening, and open conversations about mental health, cardiovascular health, bone health, and more. Importantly, this is not about creating worry; it’s about empowering people with knowledge that can improve health across a lifetime.
Did anything about the results surprise you?
D’Agata: Finding significant associations with factors such as bone density reinforced the notion that the impact of preterm birth extends beyond the organ systems typically considered. Another surprise was how little protective factors like social support appeared to offset the physical health differences, underscoring the need for systemic changes in how we monitor and care for people born preterm.