Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Preterm birth and risk of chronic kidney disease from childhood into mid-adulthood : National cohort study

Crump, Casey LU ; Sundquist, Jan LU ; Winkleby, Marilyn A. LU and Sundquist, Kristina LU (2019) In BMJ (Online) 365.
Abstract

Objective To investigate the relation between preterm birth (gestational age <37 weeks) and risk of CKD from childhood into mid-adulthood. Design National cohort study. Setting Sweden. Participants 4 186 615 singleton live births in Sweden during 1973-2014. Exposures Gestational age at birth, identified from nationwide birth records in the Swedish birth registry. Main outcome measures CKD, identified from nationwide inpatient and outpatient diagnoses through 2015 (maximum age 43 years). Cox regression was used to examine gestational age at birth and risk of CKD while adjusting for potential confounders, and co-sibling analyses assessed the influence of unmeasured shared familial (genetic or environmental) factors. Results 4305 (0.1%)... (More)

Objective To investigate the relation between preterm birth (gestational age <37 weeks) and risk of CKD from childhood into mid-adulthood. Design National cohort study. Setting Sweden. Participants 4 186 615 singleton live births in Sweden during 1973-2014. Exposures Gestational age at birth, identified from nationwide birth records in the Swedish birth registry. Main outcome measures CKD, identified from nationwide inpatient and outpatient diagnoses through 2015 (maximum age 43 years). Cox regression was used to examine gestational age at birth and risk of CKD while adjusting for potential confounders, and co-sibling analyses assessed the influence of unmeasured shared familial (genetic or environmental) factors. Results 4305 (0.1%) participants had a diagnosis of CKD during 87.0 million person years of follow-up. Preterm birth and extremely preterm birth (<28 weeks) were associated with nearly twofold and threefold risks of CKD, respectively, from birth into mid-adulthood (adjusted hazard ratio 1.94, 95%confidence interval 1.74 to 2.16; P<0.001; 3.01, 1.67 to 5.45; P<0.001). An increased risk was observed even among those born at early term (37-38 weeks) (1.30, 1.20 to 1.40; P<0.001). The association between preterm birth and CKD was strongest at ages 0-9 years (5.09, 4.11 to 6.31; P<0.001), then weakened but remained increased at ages 10-19 years (1.97, 1.57 to 2.49; P<0.001) and 20-43 years (1.34, 1.15 to 1.57; P<0.001). These associations affected both males and females and did not seem to be related to shared genetic or environmental factors in families. Conclusions Preterm and early term birth are strong risk factors for the development of CKD from childhood into mid-adulthood. People born prematurely need long term follow-up for monitoring and preventive actions to preserve renal function across the life course.

(Less)
Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMJ (Online)
volume
365
article number
l1346
publisher
BMJ Publishing Group
external identifiers
  • scopus:85065330609
  • pmid:31043374
ISSN
1756-1833
DOI
10.1136/bmj.l1346
language
English
LU publication?
yes
id
fc5ae65f-dce5-4221-a7d9-c07fc69fd71d
date added to LUP
2019-05-24 11:43:00
date last changed
2024-06-12 14:52:02
@article{fc5ae65f-dce5-4221-a7d9-c07fc69fd71d,
  abstract     = {{<p>Objective To investigate the relation between preterm birth (gestational age &lt;37 weeks) and risk of CKD from childhood into mid-adulthood. Design National cohort study. Setting Sweden. Participants 4 186 615 singleton live births in Sweden during 1973-2014. Exposures Gestational age at birth, identified from nationwide birth records in the Swedish birth registry. Main outcome measures CKD, identified from nationwide inpatient and outpatient diagnoses through 2015 (maximum age 43 years). Cox regression was used to examine gestational age at birth and risk of CKD while adjusting for potential confounders, and co-sibling analyses assessed the influence of unmeasured shared familial (genetic or environmental) factors. Results 4305 (0.1%) participants had a diagnosis of CKD during 87.0 million person years of follow-up. Preterm birth and extremely preterm birth (&lt;28 weeks) were associated with nearly twofold and threefold risks of CKD, respectively, from birth into mid-adulthood (adjusted hazard ratio 1.94, 95%confidence interval 1.74 to 2.16; P&lt;0.001; 3.01, 1.67 to 5.45; P&lt;0.001). An increased risk was observed even among those born at early term (37-38 weeks) (1.30, 1.20 to 1.40; P&lt;0.001). The association between preterm birth and CKD was strongest at ages 0-9 years (5.09, 4.11 to 6.31; P&lt;0.001), then weakened but remained increased at ages 10-19 years (1.97, 1.57 to 2.49; P&lt;0.001) and 20-43 years (1.34, 1.15 to 1.57; P&lt;0.001). These associations affected both males and females and did not seem to be related to shared genetic or environmental factors in families. Conclusions Preterm and early term birth are strong risk factors for the development of CKD from childhood into mid-adulthood. People born prematurely need long term follow-up for monitoring and preventive actions to preserve renal function across the life course.</p>}},
  author       = {{Crump, Casey and Sundquist, Jan and Winkleby, Marilyn A. and Sundquist, Kristina}},
  issn         = {{1756-1833}},
  language     = {{eng}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ (Online)}},
  title        = {{Preterm birth and risk of chronic kidney disease from childhood into mid-adulthood : National cohort study}},
  url          = {{http://dx.doi.org/10.1136/bmj.l1346}},
  doi          = {{10.1136/bmj.l1346}},
  volume       = {{365}},
  year         = {{2019}},
}