Preterm birth linked to a higher risk of disability pension in early adulthood
Using national registers, researchers examined disability pension outcomes according to gestational age among all people born in Finland between 1987 and 1990. The study followed 228,000 individuals from the age of 16 until approximately 32 years of age. The findings show that the risk of receiving a disability pension increases the earlier a person is born.
Overall, four per cent of the study population received a disability pension decision during the follow-up period. By the end of follow-up, more than 17 per cent of those born before 32 weeks of gestation were receiving a disability pension. The corresponding figures were 8.8 per cent for those born at 32-33 weeks, 5.7 per cent for those born at 34-36 weeks, and 3.7 per cent for those born at term.
A slightly increased risk of disability pension was also identified among individuals born at 37 or 38 weeks of gestation and among those born post-term. According to the researchers, this finding may have public health significance because the number of people born early term is relatively large.
Entry into disability pension immediately after the end of compulsory education was most common among those born before 32 weeks of gestation. Their risk of receiving a disability pension also increased more rapidly than in the other groups over the course of follow-up.
“The findings suggest that factors operating early in life may continue to influence work ability well into adulthood. At the same time, it is important to note that the vast majority, more than 80 per cent, of those born before 32 weeks of gestation did not receive a disability pension during the follow-up period,” says Päivi Oksanen, doctoral researcher at the University of Oulu and lead author of the study.
Among those born most prematurely, disorders of cognitive development and cerebral palsy were particularly prominent underlying causes of disability pension.
An elevated risk of disability among people born preterm has previously been reported in studies of individuals born in Sweden and Norway in the 1960s and 1970s. The findings of the new study are significant because a similar association is still evident among people born between 1987 and 1990, despite substantial advances in antenatal and neonatal care over recent decades. However, the researchers emphasise that care has continued to develop rapidly, and the results cannot be directly generalised to infants born preterm today. In light of the findings, high-quality antenatal care and continued improvements in obstetric and neonatal care remain important.
Long-term effects of preterm birth are not sufficiently recognised in healthcare
The researchers stress that further studies are needed to complement register-based evidence and to better understand how variations in gestational age affect functioning and participation in education and working life.
“Healthcare services may not always recognise the long-term and wide-ranging consequences of atypical gestational age sufficiently well. As a result, some support and treatment needs may go unnoticed, and necessary treatment and rehabilitation may not be initiated,” Oksanen says.
It is also important to investigate how early health and developmental challenges are reflected in educational and employment trajectories. For example, research on sickness absence could provide valuable insights into work ability problems long before an individual may become eligible for a disability pension.
The study was funded by the Research Council of Finland, the European Commission, the University of Oulu Graduate School, and several Finnish and international foundations. The research is part of the Health Dimensions research programme, which supports university profiling and is funded by the Research Council of Finland.
The study, Gestational age at birth and the risk of disability pension in early adulthood: a whole-population register study of people born in Finland in 1987–90, was published in the International Journal of Epidemiology.