Prematurity at birth and risk of self-injury, overdose or death in adolescence and early adulthood: A population-based cohort study

IF 3 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Annals of Epidemiology Pub Date : 2025-06-06 DOI:10.1016/j.annepidem.2025.06.002

Joel G. Ray MD MSc , Neda Pirouzmand BHSc , Alison L. Park MSc , Peter C. Austin PhD , Simone Vigod MD MSC , Sonia Grandi PhD , Howard Berger MD , Eyal Cohen MD MSc

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引用次数: 0

Abstract

Background

Preterm birth may adversely affect cortical brain development, and subsequent cognition in childhood and adolescence. Such abnormalities in brain development are correlated with suicidal and non-suicidal self-injury and persistent substance use, and to unintentional injury as well.

Objective

To evaluate the risk of self-injury, overdose, and all-cause mortality among adolescents and young adults – each in relation to preterm birth.

Design

Population-based cohort study in Ontario, Canada, where there is universal healthcare for all.

Setting

All of Ontario, Canada, where there is universal healthcare.

Participants

All youths born in Ontario from 1992 to 2012, and alive at age 10 years.

Exposures

Degree of prematurity in 2-week earlier increments, as well as preterm birth < 37 weeks’ gestation.

Outcomes

i) Primary composite of an ED visit or hospitalization for intentional self-injury, poisoning or overdose, or all-cause mortality; and ii) co-primary composite of intentional self-injury, poisoning or overdose – each assessed between ages 10–24 years.

Results

Among 2352,563 youths in the cohort, 151,182 (6.4 %) were born preterm. Adjusted hazard ratios (aHR) for i) self-injury, overdose, or all-cause mortality was 1.03 (95 % CI 1.01–1.05) per 2-week earlier gestational age at birth; and ii) 1.01 (95 % CI 0.99–1.03) for self-injury or overdose. Compared to term births, preterm birth < 37 weeks’ gestation was associated with a higher aHR for i) self-injury, overdose or all-cause mortality (1.09, 95 % CI 1.05–1.12); and ii) self-injury or overdose (1.06, 95 % CI 1.02–1.10).

Conclusion

Preterm birth may be associated with a slightly higher risk of all-cause mortality and, possibly, self-injury and overdose among adolescents and young adults. Ongoing efforts might focus on the health of youths who were born prematurely as they enter their adolescent years.

Primary funding source

Canadian Institutes of Health Research.

查看原文本刊更多论文

出生时早产与青春期和成年早期自残、用药过量或死亡的风险：一项基于人群的队列研究

背景：早产可能对儿童和青少年大脑皮质发育以及随后的认知产生不利影响。这种大脑发育异常与自杀性和非自杀性自残、持续使用药物以及无意伤害有关。目的评估青少年和年轻人与早产相关的自残、用药过量和全因死亡风险。设计以人群为基础的队列研究在加拿大安大略省，那里有全民医疗保健。加拿大安大略省的所有地区都有全民医疗保健。参与者：所有1992年至2012年在安大略省出生的10岁以下的青少年。暴露：早产程度提前2周增加，以及早产<； 妊娠37周。结果：因故意自伤、中毒或用药过量或全因死亡而去急诊科就诊或住院的主要组合；ii)故意自残、中毒或用药过量的共原发组合——每一种评估年龄在10-24岁之间。结果本组2352,563例青少年中，早产151,182例（6.4 %）。i)自伤、用药过量或全因死亡率的校正危险比（aHR）为1.03(95 % CI 1.01-1.05) /出生时早孕2周；ii) 1.01（95 % CI 0.99-1.03）为自残或过量用药。与足月分娩相比，早产<； 妊娠37周与i)自伤、用药过量或全因死亡的aHR较高相关（1.09,95 % CI 1.05-1.12）；ii)自残或用药过量（1.06,95 % CI 1.02-1.10）。结论在青少年和青壮年中，早产可能与较高的全因死亡率、自残和用药过量风险相关。正在进行的努力可能侧重于在进入青春期时过早出生的青少年的健康。主要资金来源是加拿大卫生研究所。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of Epidemiology 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.40

自引率

1.80%

发文量

207

审稿时长

59 days

期刊介绍： The journal emphasizes the application of epidemiologic methods to issues that affect the distribution and determinants of human illness in diverse contexts. Its primary focus is on chronic and acute conditions of diverse etiologies and of major importance to clinical medicine, public health, and health care delivery.