Table 1 Long-term impact of preterm birth on survivors

Specific physical effects

Visual impairment

• Blindness or high myopia after retinopathy of prematurity

• Increased hypermetropia and myopia

Around 25% of all extremely preterm affected[80]

Also risk in moderately preterm babies especially if poorly monitored oxygen therapy

Hearing impairment

Up to 5 to 10% of extremely preterm[81]

Chronic lung disease of prematurity

• From reduced exercise tolerance to requirement for home oxygen

•Increased hospital admissions in childhood for LRTI[82]

Up to 40% of extremely preterm[83]

Long-term cardiovascular ill-health and non-communicable disease

• Increased blood pressure

• Reduced lung function

• Increased rates of asthma

• Growth failure in infancy, accelerated

weight gain in adolescence

Full extent of burden still to be quantified

Neuro-developmental/ behavioral effects[84]

Mild

Disorders of executive

functioning

• Specific learning impairments, dyslexia, reduced academic achievement

Moderate to severe

Global developmental delay

• Moderate/severe cognitive impairment

• Motor impairment

• Cerebral palsy

Affected by gestational age and quality of care dependent[85]

Psychiatric/ behavioral sequelae

• Attention deficit hyperactivity disorder

• Increased anxiety and depression

Family, economic and societal effects

Impact on family

Impact on health service

Intergenerational

• Psychosocial, emotional and economic

• Cost of care[7] - acute, and ongoing

• Risk of preterm birth in offspring

Common varying with medical risk factors, disability, socioeconomic status[86]