Preemie babies face a host of potential lifelong health problems, but a new analysis suggests the cards of love might also be stacked against them.
Previous studies have found that premature babies - especially the tiniest ones - face some long-term difficulties. The issues go beyond physical health: As preemies get older they tend to lag behind their peers in school and, later, professionally. And they may be at higher risk of anxiety or certain other mental health disorders.
The new findings highlight the impact on relationships, the researchers said.
In a review of 21 studies, the investigators found that adults born preterm or underweight were less likely to have had a romantic partner or been sexually active.
Compared with their peers born full-term, their odds of having had a partner were 28% lower. And they were 57% less likely to say they'd ever had sex, the findings showed.
The difference was most pronounced among adults who'd been born very early - before the 28th week of pregnancy and/or weighing less than 2.2 pounds.
The reasons for the findings are not fully clear.
But research has shown that as they grow up, preemies tend to be more withdrawn, shy and socially excluded than their peers, explained lead researcher Marina Mendonca.
Later on, that might affect their ability to form romantic relationships, according to Mendonca, of the University of Warwick, in England.
But there won't be any one-size-fits-all explanation, other experts said.
More research needed
"The underlying factors are likely to be complex and vary among individuals," said Chiara Nosarti, of the Centre for the Developing Brain at King's College London.
Nosarti wrote an editorial that was published online with the findings July 12 in JAMA Network Open.
According to Nosarti, studies have found that preemies show "alterations" in their brain wiring and structure - including in areas related to social functioning and emotional regulation. But that doesn't mean their future is set in stone.
More research is needed, she said, to understand how a child's environment influences that brain development pattern.
"We know that babies' brains are malleable to environmental input - which makes them vulnerable to injury, but also provides early opportunities to boost their social and emotional development," Nosarti said.
For the study, Mendonca's team pooled the results of 21 studies from a dozen countries. Most included people who were born in the late 1960s through the 1980s.
At all ages, the study found, adults who'd been born preterm or underweight were less likely to have been in romantic or sexual relationships, or to be parents.
The degree of prematurity mattered, though. When it came to sexual activity, for example, adults born moderately preterm - between the 32nd and 36th weeks of pregnancy - were similar to their full-term peers.
On the other hand, adults who'd been born extremely preterm were consistently faring the worst across the three relationship measures.
Some positive findings
Tiny preemies often have lasting physical or mental disabilities. The study lacked information on disabilities - but it's likely they played some role in the findings, according to D Rahul Gupta. He is chief medical officer for the non-profit March of Dimes.
According to Gupta, the emphasis is often on the physical and mental impact of preterm birth.
"This study puts things in the social context," he said. "It gets more to the question of, 'What are their lives like?'"
However, the findings do not mean that any child is "sentenced" to a particular future, Gupta stressed. The study gives the statistical odds - but, he said, "you don't have to be that statistic".
And some findings were positive: When adults who were born preterm did have romantic partners, there was no evidence the quality of those relationships was any lower.
In addition, the outlook for preemies born in recent years might be different, Gupta noted. For one, intensive care for those newborns has improved greatly, which might have an impact on brain development.
Since premature children tend to be on the shy side, Mendonca said that helping them form friendships is important - in part, because that may help them build adulthood relationships.
Gupta agreed, and noted that every child benefits from close family relationships.
"We know that children, preterm or not, respond to a supportive, nurturing environment at home," he said.
Image credit: iStock