A new study from Karolinska Institutet, published in JAMA Pediatrics, reveals that infants who survive serious health complications in their first weeks face a significantly higher risk of death during childhood and adolescence compared to healthy newborns.
The research analyzed over two million Swedish births from 2002 to 2021. Among them, about 49,000 infants (2.4%) experienced severe neonatal conditions such as respiratory issues, neurological disorders, or infections but survived past the first month. By linking national registry data, researchers tracked subsequent deaths and their causes.
Results showed that 863 children with serious neonatal problems died later, making their risk of death nearly six times greater than that of children without such conditions. The highest risk was during the first year but remained elevated throughout childhood and adolescence. Neurological disorders posed the greatest threat, increasing mortality risk by nearly 18 times.
Lead author Hillary Graham, a PhD student at Karolinska’s Department of Medicine, emphasized the lasting impact of early health problems: “Our study shows that serious neonatal conditions can influence survival chances for years, highlighting the need for ongoing medical follow-up and support for affected children and their families.” She added, “Despite the increased risk, most children with serious neonatal health issues do survive into adulthood.”
The study also found more deaths among girls than boys with serious neonatal problems. Premature birth was common in this group but did not fully account for the higher mortality. Even full-term infants with severe health issues had a sevenfold increase in death risk compared to healthy full-term babies. Frequent causes of death included infections, and neurological, metabolic, respiratory, or circulatory disorders.
To control for family-related factors, researchers compared affected children’s mortality with that of their siblings, confirming the increased risk remained. Limitations included insufficient data on deaths among older teenagers and exclusion of twins or multiple births.
Neda Razaz, associate professor and lead researcher, stated the team’s next goal is to explore how early health problems, especially neurological disorders, affect children’s long-term development.
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