Association of Preterm Birth and Low Birth Weight With Romantic Partnership, Sexual Intercourse, and Parenthood in Adulthood: A Systematic Review and Meta-analysis

JAMA Netw Open. 2019 Jul 3;2(7):e196961. doi: 10.1001/jamanetworkopen.2019.6961.


Importance: Social relationships are important determinants of well-being, health, and quality of life. There are conflicting findings regarding the association between preterm birth or low birth weight and experiences of social relationships in adulthood.

Objective: To systematically investigate the association between preterm birth or low birth weight and social outcomes in adulthood.

Data sources: PubMed, PsycINFO, Web of Science, and Embase were searched for peer-reviewed articles published through August 5, 2018.

Study selection: Prospective longitudinal and registry studies reporting on selected social outcomes in adults who were born preterm or with low birth weight (mean sample age ≥18 years) compared with control individuals born at term.

Data extraction and synthesis: The meta-analysis followed Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. The data were collected and extracted by 2 independent reviewers. Pooled analyses were based on odds ratios (ORs) with 95% confidence intervals and Hedges g, which were meta-analyzed using random-effects models.

Main outcomes and measures: Ever being in a romantic partnership, ever having experienced sexual intercourse, parenthood, quality of romantic relationship, and peer social support.

Results: Twenty-one studies were included of the 1829 articles screened. Summary data describing a maximum of 4 423 798 adult participants (179 724 preterm or low birth weight) were analyzed. Adults born preterm or with low birth weight were less likely to have ever experienced a romantic partnership (OR, 0.72; 95% CI, 0.64-0.81), to have had sexual intercourse (OR, 0.43; 95% CI, 0.31-0.61), or to have become parents (OR, 0.77; 95% CI, 0.65-0.91) than adults born full-term. A dose-response association according to degree of prematurity was found for romantic partnership and parenthood. Overall, effect sizes did not differ with age and sex. When adults born preterm or with low birth weight were in a romantic partnership or had friends, the quality of these relationships was not poorer compared with adults born full-term.

Conclusions and relevance: These findings suggest that adults born preterm or with low birth weight are less likely to experience a romantic partnership, sexual intercourse, or to become parents. However, preterm birth or low birth weight does not seem to impair the quality of relationships with partners and friends. Lack of sexual or partner relationships might increase the risk of decreased well-being and poorer physical and mental health.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Adolescent
  • Adult
  • Coitus*
  • Humans
  • Infant, Low Birth Weight / psychology
  • Infant, Newborn
  • Interpersonal Relations*
  • Parenting / psychology*
  • Premature Birth / psychology
  • Quality of Life
  • Sexual Partners*