University of Oulu

Alenius, S., Kajantie, E., Sund, R., Nurhonen, M., Haaramo, P., Näsänen-Gilmore, P., Vääräsmäki, M., Lemola, S., Räikkönen, K., Schnitzlein, D. D., Wolke, D., Gissler, M., & Hovi, P. (2023). Risk-taking behavior of adolescents and young adults born preterm. The Journal of Pediatrics, 253, 135-143.e6.

Risk-taking behavior of adolescents and young adults born preterm

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Author: Alenius, Suvi1,2; Kajantie, Eero1,2,3,4; Sund, Reijo5;
Organizations: 1Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
2Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
3Faculty of Medicine, PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
4Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
5Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
6Faculty of Medicine and Health Technology, Tampere Center for Child, Adolescent, and Maternal Health Research: Global Health Group, Tampere University, Tampere, Finland
7Department of Psychology, Bielefeld University, Bielefeld, Germany
8Department of Psychology, University of Warwick, Warwick, UK
9Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
10Institute of Labor Economics, Leibniz University, Hannover, Germany
11Institute of Labor Economics (IZA), Bonn, Germany
12Region Stockholm, Academic Primary Health Care Center, Stockholm, Sweden; and the Karolinska Institute, Department of Molecular Medicine and Surgery, Stockholm, Sweden
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
Persistent link:
Language: English
Published: Elsevier, 2023
Publish Date: 2023-05-05


Objectives: To study sexually transmitted Chlamydia trachomatis infections (STCTs), teenage pregnancies, and payment defaults in individuals born preterm as proxies for engaging in risk-taking behavior.

Study design: Our population-based register-linkage study included all 191 705 children alive at 10 years (8492 preterm [4.4%]) born without malformations in Finland between January 1987 and September 1990 as each mother’s first child within the cohort. They were followed until young adulthood. We used Cox regression to assess the hazards of STCTs, teenage pregnancies, payment defaults, criminal offending, and substance abuse by gestational age. Gestational age was considered both as a continuous and categorical (extremely, very, moderately, late preterm, early term, post term, and full term as reference) exposure.

Results: A linear dose-response relationship existed between gestational age and STCT and teenage pregnancy; adjusted hazard for STCT decreased by 1.6% (95% CI, 0.7%‐2.6%), and for teenage pregnancy by 3.3% (95% CI, 1.9%‐4.8%) per each week decrease in gestational age. Those born extremely preterm (23‐27 completed weeks) had a 51% (95% CI, 31%‐83%) lower risk for criminal offending than their full-term born counterparts, and those born very preterm (range, 28‐31 weeks) had a 28% (95% CI, 7%‐53%) higher hazard for payment defaults than those born at full term. Gestational age was not associated with substance abuse.

Conclusions: The lower risk-taking that characterizes people born preterm seems to generalize to sexual and to some extent criminal behavior. Those born very preterm are, however, more likely to experience payment defaults.

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Series: Journal of pediatrics
ISSN: 0022-3476
ISSN-E: 1097-6833
ISSN-L: 0022-3476
Volume: 253
Pages: 135 - 146.e6
DOI: 10.1016/j.jpeds.2022.09.032
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: Supported by the Academy of Finland (Skidi-Kids program for 2010-2013 and grants 127437, 129306, 130326, 134791, 263924, 274794, 315690 [to E.K.]); and the Academy of Finland (Clinical Researcher Grant 288966 [to P.Ho.]); the Academy of Finland (grant number 1324596 [to K.R.]); European Commission (Horizon 2020 award RECAP Research on Children and Adults Born Preterm grant number 733280 [to E.K., K.R., D.W.]); the Doctoral Programs of Public Health, University of Helsinki [to S.A.]; the Finnish Foundation for Pediatric Research [to E.K., P.Ho.], the Signe and Ane Gyllenberg Foundation [to S.A., E.K., P.Ho.]; the Alli Paasikivi Foundation [to P.Ho.]; the Sigrid Jusélius Foundation [to E.K.]; the Juho Vainio Foundation [to E.K., S.A.]; Norface DIAL Programme (project 462-16-040 Premlife Life Course Dynamics after Preterm Birth [to E.K., K.R., D.S., D.W., S.L.]); the Novo Nordisk Foundation [to E.K.]; the Finnish Foundation for Cardiovascular Research [to E.K., P.Ho.]; the Emil Aaltonen Foundation [to E.K., P.Ho.]; the Paulo Foundation [to S.A.]; the Finnish Medical Foundation [to S.A.]; and the Päivikki and Sakari Sohlberg Foundation [to S.A.]. The study funders had no role in design and conduct of the study; collection, management, analysis, and interpretation of the data; writing, preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.
EU Grant Number: (956454) RecaP - Capture, recycling and societal management of phosphorus in the environment
Academy of Finland Grant Number: 127437
Detailed Information: 127437 (Academy of Finland Funding decision)
129306 (Academy of Finland Funding decision)
130326 (Academy of Finland Funding decision)
134791 (Academy of Finland Funding decision)
263924 (Academy of Finland Funding decision)
274794 (Academy of Finland Funding decision)
315690 (Academy of Finland Funding decision)
Copyright information: © 2022 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (