Multisystem morbidity in preterm survivors: Associations with birthweight-for-gestational-age status from birth to adolescence

Ruta Morkuniene; Ruta Levuliene; Janina Tutkuviene

doi:10.20330/AnthropKozl.2026.67s.62

Ruta Morkuniene Vilnius University, Faculty of Medicine, Institute of Biomedical Sciences, Department of Anatomy, Histology and Anthropology, Vilnius, Lithuania
Ruta Levuliene Vilnius University, Institute of Applied Mathematics, Vilnius, Lithuania
Janina Tutkuviene Vilnius University, Faculty of Medicine, Institute of Biomedical Sciences, Department of Anatomy, Histology and Anthropology, Vilnius, Lithuania

DOI: https://doi.org/10.20330/AnthropKozl.2026.67s.62

Absztrakt

Background: Preterm birth is associated with increased long-term morbidity, yet health outcomes are often analysed within separate organ systems. Less is known about how disease burden and co-occurring morbidity patterns differ according to birthweight-for-gestational-age status from birth to adolescence.

Objective: To assess disease burden, International Classification of Diseases, 10th Revision (ICD-10) disease chapter involvement, and morbidity co-occurrence patterns in preterm children according to small-, appropriate-, and large-for-gestational-age (SGA, AGA, and LGA) status.

Subjects and methods: A retrospective longitudinal study included 420 preterm children followed until adolescence (202 boys, 218 girls; born in 2000–2015). First-time diagnoses from medical records (n=1,818) were classified by ICD-10. Children were categorised as SGA, AGA, or LGA. Outcomes were analysed using Poisson and negative binomial regression.

Results: The primary disease burden was concentrated from birth to preschool age. Compared with SGA children, AGA and LGA children had significantly lower incidence rates of separate diseases (IRR 0.825, p=0.004; IRR 0.709, p=0.003) and affected ICD-10 chapters (IRR 0.812, p=0.008; IRR 0.692, p=0.009). Five or more diseases were recorded in 55% of SGA, 39% of AGA, and 25% of LGA children, while five or more ICD-10 disease chapters were affected in 44%, 28%, and 18%, respectively. Differences were significant between SGA and both AGA and LGA groups (p<0.05), but not between AGA and LGA (p=0.365). UpSet analysis showed unique morbidity profiles in 89.1% of SGA, 37.8% of AGA, and 92.9% of LGA children.

Conclusions: SGA status in preterm children was associated with greater long-term disease burden and broader ICD-10 disease chapter involvement. Morbidity profiles were highly heterogeneous, indicating that preterm health outcomes should be evaluated as multisystem and individualised rather than organ-specific outcomes alone.

Hivatkozások

References: None.