'The child is father of the man'-why we need to ask adults about their childhood.

Abstract

Last December the Fellowship of Postgraduate Medicine held a conference at the Royal College of Physicians of London, marking the centenary of the death of Sir William Osler. One of the main presentations in the morning was by Professor Neena Modi, former president of the Royal College of Paediatrics and Child Health, and now president of the Medical Women’s Federation. She spoke about research into the links between premature birth and disease in adult life. She also drew attention to how unusual it is for a paediatrician to be addressing an audience made up largely of physicians working with older patients, and she made a strong case for them to become more curious, and better informed, about how early life might affect the grown-ups they see every day in their consulting rooms and on the wards. Professor Modi and co-author Emily Prior now make the same case in a paper in this month’s Postgraduate Medical Journal .1 As they show, the facts about the enduring medical impact of premature birth are alarming. To summarise, prematurity is associated with a mean increase in systolic blood pressure of 4.2 mmHg, and in diastolic pressure of 2.6 mmHg. Lean body mass is lower and internal abdominal adipose tissue is higher. There is evidence for preterm birth as an independent risk factor for type two diabetes, ischaemic heart disease, heart failure and chronic kidney disease, while birth before 32 weeks is associated with a nearly twofold increased risk of cerebrovascular disease. Preterm adults show evidence of disruption …