Dataset Information

Association of Preterm Birth and Low Birth Weight With Romantic Partnership, Sexual Intercourse, and Parenthood in Adulthood: A Systematic Review and Meta-analysis.

ABSTRACT:

Importance

Social relationships are important determinants of well-being, health, and quality of life. There are conflicting findings regarding the association between preterm birth or low birth weight and experiences of social relationships in adulthood.

Objective

To systematically investigate the association between preterm birth or low birth weight and social outcomes in adulthood.

Data sources

PubMed, PsycINFO, Web of Science, and Embase were searched for peer-reviewed articles published through August 5, 2018.

Study selection

Prospective longitudinal and registry studies reporting on selected social outcomes in adults who were born preterm or with low birth weight (mean sample age ≥18 years) compared with control individuals born at term.

Data extraction and synthesis

The meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The data were collected and extracted by 2 independent reviewers. Pooled analyses were based on odds ratios (ORs) with 95% confidence intervals and Hedges g, which were meta-analyzed using random-effects models.

Main outcomes and measures

Ever being in a romantic partnership, ever having experienced sexual intercourse, parenthood, quality of romantic relationship, and peer social support.

Results

Twenty-one studies were included of the 1829 articles screened. Summary data describing a maximum of 4 423 798 adult participants (179 724 preterm or low birth weight) were analyzed. Adults born preterm or with low birth weight were less likely to have ever experienced a romantic partnership (OR, 0.72; 95% CI, 0.64-0.81), to have had sexual intercourse (OR, 0.43; 95% CI, 0.31-0.61), or to have become parents (OR, 0.77; 95% CI, 0.65-0.91) than adults born full-term. A dose-response association according to degree of prematurity was found for romantic partnership and parenthood. Overall, effect sizes did not differ with age and sex. When adults born preterm or with low birth weight were in a romantic partnership or had friends, the quality of these relationships was not poorer compared with adults born full-term.

Conclusions and relevance

These findings suggest that adults born preterm or with low birth weight are less likely to experience a romantic partnership, sexual intercourse, or to become parents. However, preterm birth or low birth weight does not seem to impair the quality of relationships with partners and friends. Lack of sexual or partner relationships might increase the risk of decreased well-being and poorer physical and mental health.

SUBMITTER: Mendonca M

PROVIDER: S-EPMC6628597 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:Preterm birth survivors are at a higher risk of growth and developmental disabilities compared to their term counterparts. Development of strategies to lower the complications of preterm birth forms the rising need of the hour. Appropriate nutrition is essential for the growth and development of preterm infants. Early administration of optimal nutrition to preterm birth survivors lowers the risk of adverse health outcomes and improves cognition in adulthood. A group of neonatologists, pediatricians, and nutrition experts convened to discuss and frame evidence-based recommendations for optimizing nutrition in preterm low birth weight (LBW) infants. The following were the primary recommendations of the panel: (1) enteral feeding is safe and may be preferred to parenteral nutrition due to the complications associated with the latter; however, parenteral nutrition may be a useful adjunct to enteral feeding in some critical cases; (2) early, fast, or continuous enteral feeding yields better outcomes compared to late, slow, or intermittent feeding, respectively; (3) routine use of nasogastric tubes is not advisable; (4) preterm infants can be fed while on ventilator or continuous positive airway pressure; (5) routine evaluation of gastric residuals and abdominal girth should be avoided; (6) expressed breast milk (EBM) is the first choice for feeding preterm infants due to its beneficial effects on cardiovascular, neurological, bone health, and growth outcomes; the second choice is donor pasteurized human milk; (7) EBM or donor milk may be fortified with human milk fortifiers, without increasing the osmolality of the milk, to meet the high protein requirements of preterm infants; (8) standard fortification is effective and safe but does not fulfill the high protein needs; (9) use of targeted and adjustable fortification, where possible, helps provide optimal nutrition; (10) optimizing weight gain in preterm infants prevents long-term cardiovascular complications; (11) checking for optimal weight and sucking/swallowing ability is essential prior to discharge of preterm infants; and (12) appropriate counseling and regular follow-up and monitoring after discharge will help achieve better long-term health outcomes. This consensus summary serves as a useful guide to clinicians in addressing the challenges and providing optimal nutrition to preterm LBW infants.

Project description:ImportanceLow birth weight and preterm birth are associated with adverse consequences including increased risk of infant mortality and chronic health conditions. Black infants are more likely than white infants to be born prematurely, which has been associated with disparities in infant mortality and other chronic conditions.ObjectiveTo evaluate whether Medicaid expansion was associated with changes in rates of low birth weight and preterm birth outcomes, both overall and by race/ethnicity.Design, setting, and participantsUsing US population-based data from the National Center for Health Statistics Birth Data Files (2011-2016), difference-in-differences (DID) and difference-in-difference-in-differences (DDD) models were estimated using multivariable linear probability regressions to compare birth outcomes among infants in Medicaid expansion states relative to non-Medicaid expansion states and changes in relative disparities among racial/ethnic minorities for singleton live births to women aged 19 years and older.ExposuresState Medicaid expansion status and racial/ethnic category.Main outcomes and measuresPreterm birth (<37 weeks' gestation), very preterm birth (<32 weeks' gestation), low birth weight (<2500 g), and very low birth weight (<1500 g).ResultsThe final sample of 15 631 174 births (white infants: 8 244 924, black infants: 2 201 658, and Hispanic infants: 3 944 665) came from the District of Columbia and 18 states that expanded Medicaid (n = 8 530 751) and 17 states that did not (n = 7 100 423). In the DID analyses, there were no significant changes in preterm birth in expansion relative to nonexpansion states (preexpansion to postexpansion period, 6.80% to 6.67% [difference: -0.12] vs 7.86% to 7.78% [difference: -0.08]; adjusted DID: 0.00 percentage points [95% CI, -0.14 to 0.15], P = .98), very preterm birth (0.87% to 0.83% [difference: -0.04] vs 1.02% to 1.03% [difference: 0.01]; adjusted DID: -0.02 percentage points [95% CI, -0.05 to 0.02], P = .37), low birth weight (5.41% to 5.36% [difference: -0.05] vs 6.06% to 6.18% [difference: 0.11]; adjusted DID: -0.08 percentage points [95% CI, -0.20 to 0.04], P = .20), or very low birth weight (0.76% to 0.72% [difference: -0.03] vs 0.88% to 0.90% [difference: 0.02]; adjusted DID: -0.03 percentage points [95% CI, -0.06 to 0.01], P = .14). Disparities for black infants relative to white infants in Medicaid expansion states compared with nonexpansion states declined for all 4 outcomes, indicated by a negative DDD coefficient for preterm birth (-0.43 percentage points [95% CI, -0.84 to -0.02], P = .05), very preterm birth (-0.14 percentage points [95% CI, -0.26 to -0.02], P = .03), low birth weight (-0.53 percentage points [95% CI, -0.96 to -0.10], P = .02), and very low birth weight (-0.13 percentage points [95% CI, -0.25 to -0.01], P = .04). There were no changes in relative disparities for Hispanic infants.Conclusions and relevanceBased on data from 2011-2016, state Medicaid expansion was not significantly associated with differences in rates of low birth weight or preterm birth outcomes overall, although there were significant improvements in relative disparities for black infants compared with white infants in states that expanded Medicaid vs those that did not.