Newborns with health problems are at higher risk of dying into adolescence
Infants who survive serious health problems in the first few weeks of life have a higher risk of dying during childhood and adolescence compared to children who were healthy as newborns. This is according to a new study from Karolinska Institutet published in the journal JAMA Pediatrics.
The study covers over two million babies born in Sweden between 2002 and 2021, about 49,000 (2.4 per cent) of whom had serious health problems in the neonatal period, such as respiratory problems, neurological disorders or severe infections, but survived the first four weeks after birth. Using national registries, the researchers were able to determine the number of deaths that occurred later in life and the cause of death.
The vast majority survive
The results show that 863 of the children who had serious health problems as newborns died later in life, and were almost six times more likely to die during childhood and adolescence compared to children without such problems. The risk was highest in the first year of life but remained elevated in subsequent years. Children with neurological health problems had the highest risk of dying – almost 18 times higher than healthy children.
“Our study shows that serious health problems in newborns can affect the child’s chances of survival for many years to come,” says lead author Hillary Graham, PhD student at the Department of Medicine, Solna, Karolinska Institutet. “Therefore, it is important that these children are followed up throughout childhood and adolescence and that their families receive long-term support from the healthcare system.”
“At the same time, it is important to emphasise that although the risk of death is increased, the vast majority of children with serious health problems in the neonatal period survive to adulthood,” she continues.
More girls than boys died
Among children with serious health problems, more girls than boys died. Children born prematurely were also overrepresented, but the increase in risk could not be fully explained by premature birth. Compared to healthy full-term babies, full-term babies with serious health problems had a seven-fold increased risk of death. Common causes of death were infections and neurological, metabolic, respiratory or circulatory disorders.
The researchers compared the children’s risk of death with their siblings to account for shared family-related factors, but the increase in risk remained. One limitation is that they could not fully study deaths in older teenagers because only some of the study participants had reached that age by the end of the study. They also did not study twins or other multiple births.
“The next step in our research is to expand the studies on how these early health problems in infants can affect children’s long-term development, especially among children with neurological disorders,” says Neda Razaz, associate professor at the Department of Medicine, Solna, Karolinska Institutet, who led the research.
The study was funded by the Swedish Research Council and Region Stockholm (ALF funds). There are no reported conflicts of interest.
Publication
“Severe Neonatal Morbidity and All-Cause and Cause-Specific Mortality Through Infancy and Late Adolescence”, Hillary Graham, Kari Johansson, Martina Persson, Mikael Norman, Neda Razaz, JAMA Pediatrics, online 10 June 2025, doi: 10.1001/jamapediatrics.2025.1873.