Abstract / Summary
Preterm birth is a significant early-life adversity linked to increased risk for chronic disease across the lifespan. Allostatic load, a measure of cumulative physiological wear and tear across multiple biological systems, may provide insight into the long-term biological consequences of early-life medical adversity. Leveraging data from the 35-year RHODE Study, we investigated whether early medical risk associated with preterm birth predicted accelerated epigenetic aging and allostatic load. This prospective longitudinal cohort study used birth (1985–1989) and childhood data with follow-up at age 35. The cohort included preterm individuals with varied neonatal diagnoses and a healthy full-term group. Of 215 original participants, 124 provided biological samples at 35 (mean=35 years; 51 male). We examined how medical risk severity (ages 0-12) predicted epigenetic age acceleration and allostatic load at age 35. Here we show that higher medical risk is associated with elevated allostatic load and intrinsic and extrinsic epigenetic age acceleration of a first-generation epigenetic clock, independent of childhood socioeconomic status. Lower childhood socioeconomic status is associated with higher allostatic load and epigenetic age acceleration in second-generation clocks. Associations did not differ by sex. Higher early-life medical risk is associated with epigenetic age acceleration and allostatic load in adulthood. These findings add to growing evidence that preterm birth is a lifelong health determinant, underscoring the importance of clinical practice recognizing birth history as a critical factor to mitigate long-term morbidity. People born preterm (before 37 weeks of pregnancy) are more likely to develop health problems later in life, but less is known about how preterm birth affects aging. This study followed adults from birth to age 35 as part of the RHODE Study, which began in the late 1980s. Researchers reviewed records from infancy and childhood and measured signs of aging in adulthood using blood tests and epigenetic changes associated with aging. Adults who experienced more serious medical problems early in life showed signs of faster aging by their mid-30s. These findings suggest that preterm birth can influence health across the lifespan and support the need for earlier health screening and prevention efforts for adults born preterm. Parent et al. studied whether medical complications linked to preterm birth are associated with faster biological aging by age 35. Adults with more severe early life medical problems showed greater physiological stress and signs of accelerated aging in adulthood.