A large study on the long-term consequences of premature birth – premature babies were followed for forty years

November 16, 2022

Every year, about 7 percent of babies in the Netherlands are born prematurely, and worldwide this figure is 10 percent. November 17, 2022 is all about these babies, as it is the International Day of Prematurity. The TNO has been using the POPS study since 1983 to research the development and health of almost all premature babies born in the Netherlands that year. Radboudumc is involved in this research and is looking specifically at the consequences of premature birth on the kidneys. Together with TNO and Care4Neo, pediatric nephrologist Michelle Schroeder stresses the importance of continuing to monitor these children and adults.

The POP group includes 1336 subjects born in 1983 with a gestational age of less than 32 weeks and/or a birth weight of less than 1500 grams. This represented 94% of all babies born prematurely or with a very low birth weight in the Netherlands in 1983. Over the years, the group has provided a great deal of information about the short- and long-term consequences for those around 40 years of age. Nowhere in the world has a group of this magnitude been so nationally followed and studied so extensively for such a long period of time.

Continuing study pops

The last physical examination was done in 2001, when premature babies were 19 years old. TNO, along with several academic hospitals, then investigated the medical and psychological and social functioning of the POPS participants. At ages 28 and 35, the group was surveyed online using questionnaires. Outcomes were examined in the domains of quality of life, life course, relationships, and pregnancy.

TNO researcher Sylvia van der Pal: “We would like to follow this up, ideally with a thorough physical exam. The fact that the participants in the POP group are now almost 40 years old and in a new phase of life is a good time for the next measurement. Additionally Study results 19, 28 and 35 years after birth indicate that it is important to monitor the long-term consequences of preterm birth.

The importance of long-term tracking

Michel Schroeder is Professor of Pediatric Nephrology at the Radbodomek Amalia Children’s Hospital. He says: “Premature birth is actually a living experience. We are saving these babies, young and young, but it is also important to know what it means for their future and how you can prevent any problems. By the age of 19, 50% have high blood pressure. It may not lead to Problems at this age, but there is a good chance that it will happen at a later age. Do not expect kidney damage at this age, it takes time. You may already see damage at the age of 40, but it may not appear until later. The truth is that With an unhealthy predisposition to the kidneys, the risk of damage later in life is greater.The same applies to diabetes and lung damage, for example.It is important to look for complaints that occur in this group throughout life, so that we can take preventive measures against them.In this way Not only this group, but also babies who are now born prematurely benefit from the knowledge that the group of pops provides.

According to Schroeder, one problem is that premature birth is already getting attention in pediatrics, but once the transition to adult care is made around the age of 18, the impact of premature birth fades into the background. “Now only the most vulnerable preterm babies are being followed up until the age of eight, but puberty hasn’t quite come yet at that point. So it would be great if we could use the new POP study to show the causes of preterm birth in adults,” says Schroeder.

More knowledge about the kidneys, brain and lungs

It is currently being examined whether and how a follow-up to the POPS study can be done. van der Pal: “We are now mapping out what we want to look at. We are also looking for researchers who are interested in this group based on their experience and who would like to participate in a new measurement. It would be nice if we could screen premature adults for a number of additional things compared to the measurement at 19 In any case, the participants from the group are excited, and I often receive emails asking if there is another round.

“I hope that some of the people who didn’t partake online the last two times will now want to do so when it comes to a physical examination. How wonderful that research is being done in so many areas, including: brain development, kidney damage, blood pressure, insulin, cardiovascular, body composition, lung problems, pregnancy problems, fertility and psychosocial topics. Schroeder believes that clarity is needed in many aspects, among scientists and clinicians, as well as premature babies and their parents.

This letter is an abbreviated version of this TNO article on the study of Pops in the context of World Prematurity Day on Thursday 17 November. Read more about Care4Neo here. Pictured: Michelle Schroeder.

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