Abstract
Social relationships are important determinants of well-being, health, and quality of life. There are conflicting findings regarding the association between preterm birth or low birth weight and experiences of social relationships in adulthood. To systematically investigate the association between preterm birth or low birth weight and social outcomes in adulthood. PubMed, PsycINFO, Web of Science, and Embase were searched for peer-reviewed articles published through August 5, 2018. Prospective longitudinal and registry studies reporting on selected social outcomes in adults who were born preterm or with low birth weight (mean sample age ≥18 years) compared with control individuals born at term. The meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The data were collected and extracted by 2 independent reviewers. Pooled analyses were based on odds ratios (ORs) with 95% confidence intervals and Hedges g, which were meta-analyzed using random-effects models. Ever being in a romantic partnership, ever having experienced sexual intercourse, parenthood, quality of romantic relationship, and peer social support. Twenty-one studies were included of the 1829 articles screened. Summary data describing a maximum of 4 423 798 adult participants (179 724 preterm or low birth weight) were analyzed. Adults born preterm or with low birth weight were less likely to have ever experienced a romantic partnership (OR, 0.72; 95% CI, 0.64-0.81), to have had sexual intercourse (OR, 0.43; 95% CI, 0.31-0.61), or to have become parents (OR, 0.77; 95% CI, 0.65-0.91) than adults born full-term. A dose-response association according to degree of prematurity was found for romantic partnership and parenthood. Overall, effect sizes did not differ with age and sex. When adults born preterm or with low birth weight were in a romantic partnership or had friends, the quality of these relationships was not poorer compared with adults born full-term. These findings suggest that adults born preterm or with low birth weight are less likely to experience a romantic partnership, sexual intercourse, or to become parents. However, preterm birth or low birth weight does not seem to impair the quality of relationships with partners and friends. Lack of sexual or partner relationships might increase the risk of decreased well-being and poorer physical and mental health.
Highlights
IntroductionPreterm birth or low birth weight (PT/LBW) is associated with an increased risk for disability,[1,2] neurocognitive impairment,[3,4,5,6] learning difficulties,[3,6] and mental health problems,[7,8,9] with the association being stronger for those with lower gestational age.[3,10,11,12] These functional deficits are associated with adverse impacts on preterm-born adults’ socioeconomic outcomes.[13]
We identified 5 studies for number of friends,[32,33,34,42,43] but they were not included in the quantitative synthesis owing to the different ways the number of friends was assessed across studies
The number of participants included in each analysis of summary data ranged from 4 423 798 (179 724 Preterm birth or low birth weight (PT/LBW)) for parenthood to 648 (276 PT/LBW) for peer social support (Table 2)
Summary
Preterm birth or low birth weight (PT/LBW) is associated with an increased risk for disability,[1,2] neurocognitive impairment,[3,4,5,6] learning difficulties,[3,6] and mental health problems,[7,8,9] with the association being stronger for those with lower gestational age.[3,10,11,12] These functional deficits are associated with adverse impacts on preterm-born adults’ socioeconomic outcomes.[13]. Intimate, and supportive relationships are associated with increased happiness and well-being,[14,15] good physical health,[16] and good mental health.[17] Studies have shown that social relationships are more challenging for children born PT/LBW.[18] prematurity has been associated with a behavioral phenotype[18,19,20] and personality profile[21,22,23,24] that includes being timid, socially withdrawn, overcontrolling, and disinclined toward risk-taking or fun seeking. These differences may predispose PT/LBW individuals to face greater difficulties in establishing romantic and peer relationships
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