Infants born prematurely are much more likely to die during childhood and, if they survive, they're much less likely to have children of their own in adulthood, according to the largest study of prematurity undertaken.

Researchers already knew that premature infants faced many neurological and developmental problems, but the new findings, released today, indicate that the spectrum of problems is even broader than suspected and persist throughout the child's lifetime.

The study, conducted using Norwegian data, suggests that, as the percentage of premature infants who make it through their first year continues to grow because of advances in neonatology, the number of troubled infants and adults also will rise.

"Are we improving their survival at the expense of significant problems down the road?" asked the lead author, Dr. Geeta Swamy of the Duke University Medical Center.

The situation probably is worse in the United States because of racial disparities in the care of newborns, Melissa Adams of RTI International in Atlanta and Dr. Wanda Barfield of the federal Centers for Disease Control and Prevention wrote in an editorial accompanying the report in the Journal of the American Medical Association.

"This is an important paper because it documents something we have all known in our hearts - that being born premature has enduring implications," said Dr. William Benitz, chief of the division of neonatal and developmental medicine at Lucile Packard Children's Hospital at Stanford University. "Most of the babies do pretty well in the long run. But a substantial portion of them have problems.

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