Most adults born very premature go on to thrive, but one in five face lasting economic and social struggles

A landmark 34-year study, co-led by the University of Warwick, tracks very preterm babies from birth to middle adulthood and identifies early cognitive development as the strongest predictor of who flourishes and struggles as adults.

The majority of adults born very preterm or at very low birth weight go on to build stable, satisfying lives in their mid-30s, but around one in five face a cluster of lasting difficulties with employment, romantic relationships and friendships, according to new research published in JAMA Pediatrics.

The Bavarian Longitudinal Study, led by Professor Dieter Wolke at the University of Warwick, followed 416 adults, 214 of whom were born very preterm (before 32 weeks) or at very low birth weight (under 3.3 pounds/1.5 kg), from birth in the mid-1980s to age 34, making it one of the longest-running cohort studies of its kind internationally.

Using detailed life-course interviews covering risk avoidance, wealth and relationships with parents, partners and friends, researchers identified three distinct patterns of adult functioning:

Optimal functioning (full term: 74%; preterm: 56%): doing well across all areas of life.