Objective: To investigate whether being born preterm with very low birth weight (VLBW), lower best-corrected visual acuity (BCVA) or a history of a psychiatric or somatic diagnosis is associated with, or mediates, not having obtained a driver's licence at adult age.
Methods and analysis: Potential predictors of no driver's licence were investigated in participants with a mean age of 36 years and BCVA above the legal limit to drive from the Norwegian University of Science and Technology Low Birth Weight Life Study, Norway, and the Helsinki Study of Very Low Birth Weight Adults, Finland, (VLBW n=119, term-born controls n=149).
Results: Participants with no driver's licence (n=34) had lower BCVA than participants with a driver's licence (mean logarithm of the minimal angle of resolution (SD) -0.03 (0.11) vs -0.101 (0.09), p<0.001. Being born with VLBW and lower BCVA was associated with no driver's licence (OR, 2.5 (95% CI 1.1 to 5.8) and 1.1 per unit (95% CI 1.0 to 1.2), respectively. BCVA was not a mediator of the effect of being born preterm with VLBW.
Conclusion: In a population with good visual acuity, being born preterm with VLBW was a predictor for not having a driver's licence, while lower visual acuity further increased this likelihood. A history of a somatic or psychiatric diagnosis was not associated. These findings should be interpreted with caution due to the relatively small sample size and a non-negligible statistical uncertainty. The causal relationship between being born preterm and not holding a driver's licence remains to be investigated.
Keywords: Child health (paediatrics); Epidemiology.
© Author(s) (or their employer(s)) 2026. Re-use permitted under CC BY. Published by BMJ Group.