Adulthood
A recent editorial accompanying the 15-year CRYO-ROP follow-up was titled, "Premature for Life". This whimsical phrase perfectly sums up the underlying theme of this talk. The great majority of preterms have longterm consequences of their prematurity that must be recognized, acknowledged and dealt with.

We have so far discussed the short and moderate term outcomes of prematurity up to adolescence, but what about adulthood? There are few reports of adult survivors of prematurity, only one from the U.S. This study evaluated VLBWs at age 20. A recent Canadian study assessed ELBWs at age 23. The young adults in these 2 reports were born between 1977 and 1982. Both studies looked at important components of adult status.

The five traditional markers of the transition from childhood to adulthood are:


  • educational attainment
  • getting a job
  • living independently
  • getting married
  • parenthood

Considering these markers, the adult follow-up studies report that 75-85% of adult ex-premies had graduated from high school, about 30% were enrolled in college. The VLBW group reported less alcohol and drug use than NBW controls. 48% of the ELBWs had permanent employment. There were no differences between ELBWs and NBWs in living arrangements. 25% of both groups of ex-premies were married and 13% were parents.

These figures seem surprisingly rosy after the gloomy outlook of younger follow-up ages. Add to this the results of a self-assessment of QOL by ELBW adolescents. That study showed virtually no difference between ELBW and NBW teenagers in the proportion of QOL ratings greater than 0.95, where 0=death and 1=perfect health. The authors postulate that "disabled children may gradually accept their disabilities, adjust their expectations and experience a higher QOL than would be predicted by nondisabled persons." The Canadian study ends by saying,


"It appears that, against all odds, a significant majority of ELBWs have overcome their earlier difficulties to become functional young adults in terms of educational attainment, employment and independent living."

This gives hope for an eventual happy and satisfying outcome for our premature patients and their parents.

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