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 machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.014 | 0.030 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 source (direct Gemma or distilled Codex), 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".