Outcomes in Early Adulthood for Individuals Born Very Preterm and/or with Very Low Birth Weight: Evidence from Multinational Cohorts
Bibliographic record
Abstract
Background: Advances in neonatal care have improved survival rates for infants born very preterm (VP) and/or with very low birth weight (VLBW), yet their long-term outcomes into adulthood remain understudied. Objectives: To assess the impact of VP/VLBW status on mortality, educational attainment, and labor market outcomes in early adulthood using data from the RECAP Preterm Project. Methods: We used harmonized data from 5 nationally representative cohort studies in high-income countries (Canada, Germany, the Netherlands, New Zealand, and Norway) participating in the RECAP Preterm Project. Our sample included 2493 individuals born VP/VLBW and 496 control patients born at term. We used coarsened exact matching to compare adult outcomes between infants who were VP/VLBW and those born at term and an instrumental variable approach-using maternal nulliparity-to estimate the marginal effect of gestational age within the VP/VLBW group. Results: Mortality before adulthood was 16.7 percentage points greater among individuals who were VP/VLBW compared with control infants born at term (95% CI 13.2-20.2). Among survivors, the likelihood of attaining less than secondary education was 4.3 percentage points greater (95% CI -0.8 to 9.4). Differences in economic activity and working hours were small and uncertain. Within the VP/VLBW group, each additional week of gestational age was associated with a 6.8 percentage point reduction in mortality (95% CI -12.7 to -1.0), with weaker associations for educational and labor market outcomes. Conclusions: VP/VLBW birth is associated with elevated mortality and educational disadvantage in early adulthood. These findings highlight the importance of long-term support for this population beyond neonatal survival, particularly in education and development policy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.030 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".