Birth history is forever: Implications for family medicine

The rapidly growing number of adult survivors of preterm birth has necessitated and made possible for the first time large-scale investigations of long-term outcomes of preterm birth. Large epidemiologic studies have shown that the long-term sequelae are wide-ranging, including metabolic disorders, cardiovascular and respiratory disease, psychiatric disorders, and increased mortality risk. Clinicians should now recognize preterm birth as a long-term, multidisease risk factor in adults. These research findings contribute to a growing body of evidence of early life programming for chronic disease, which in turn supports a "life course" paradigm for patient care. Family medicine is an ideally conceived discipline for this paradigm because of its unique role in caring for patients across the entire life span. As our understanding of early life influences on long-term health continues to advance, family physicians are ideally positioned to incorporate this knowledge into clinical practice.