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Vital Signs

When premies grow up

This month, researchers at the University of Rhode Island’s College of Nursing will present their latest findings from a 23-year-long study of premature infants, the longest running study of its kind in the United States, at the Congress of the European Group of Pediatric Work Physiology at the University of Exeter in Great Britain.

Mary C. Sullivan, the study’s principal investigator since 2002, is a professor of nursing at URI, research scientist at Women and Infants Hospital, and an adjunct professor of pediatrics at Alpert Medical School at Brown University. Sullivan will be presenting the findings at Exeter with co-investigator, cardiologist Jim Zeigler.

In June, 2011 the study released findings that babies with preterm births are less healthy, have more social and academic challenges, and as adults have a greater risk of heart-health problems. The latest research is based on the hypothesis that the higher production of the hormone cortisol, a stress response of pre-term infants by the hypothalamic-pituitary adrenal (HPA) axis, is a fetal origin of chronic disease when these infants reach adulthood. The research compared cortisol levels and medical and neurological health in adults who were born full-term and preterm. Cortisol is essential for immune response, vascular tone, regulating metabolism, and homeostasis, important areas particularly in cardiovascular health.

Launched by Brown University in 1985, the study has followed the development of 213 individuals since age 4, comparing four categories of pre-term infants with one control group of full-term healthy infants into young adulthood. 96% of the group has continued their participation over the years, and the study is about to embark on the next phase of research, monitoring the subjects into middle age.

Infants with medical and neurological impacts from preterm births have a 24–32% higher rate of acute and chronic health conditions. Early findings have shown that adults with higher resting blood pressures were born at very low birth weights, one of the effects of a preterm birth.

A major question of the study surrounds whether or not infants are resilient enough to correct setbacks from a pre-term birth, but research has shown that preterm infants without medical or neurological illnesses experience more subtle challenges as they develop, such as learning disabilities, delays in physical development, challenges with coordination, and setbacks socially. A positive trend in the study found that parents who were nurturing and strong advocates for their children, displaying what the study calls protective factors, countered some negative effects of pre-term birth, with results in better performance academically, socially, and physically than those subjects born pre-term without similar support.