Grant: Project Grant

With advances in neonatal care, more of the 21,000 babies born in Canada each year at extremely low birth weight (ELBW; less than 1000 g at birth) are surviving. Individuals born extremely preterm face a range of difficulties, affecting their vision, breathing, motor coordination, metabolic, cardiovascular and kidney function, attention, mood, and social integration. These problems do not appear to resolve in adulthood. ELBW survivors are also at greater risk than adults born at normal birth weight (NBW; more than 2500 g at birth) for health-threatening chronic diseases such as hypertension and diabetes at a relatively young age. The McMaster University Cohort is the oldest-known cohort of ELBW survivors in the world. They are now entering their 40s, a life stage that requires active management to maintain physical and psychological health. However, the long-term physical and psychological consequences of being born extremely preterm are unknown and of critical importance. The first goal of the proposed study is to assess the physical, mental, economic, and social challenges faced by ELBW survivors at middle age. This will determine the current health status of ELBW survivors, and also establish valuable benchmarks against which to compare future age-related risks for disease and cognitive decline. Some factors (e.g., differences in brain structure and metabolic regulation) are likely to continue to impact preterm health as the cohort ages, but others may be modifiable. Therefore, the second goal of this study is to identify resilience factors that will modify ELBW outcomes beyond middle age. These factors will provide potential targets for interventions to promote long-term good health and optimal aging in ELBW survivors.