Preterm Birth Risk Factors, Epigenetic Age, and Later Neurodevelopmental Outcomes

By
Rhandi Christensen
Chaini Konwar
Beryl C. Zhuang
Julia MacIsaac
Vann Chau
Mehmet N. Cizmeci
Linh G. Ly
Ting Guo
Helen Branson
Michael S. Kobor
Ruth E. Grunau
Steven P. Miller
October 16, 2026

Jama Network Open

Overview

The source describes a prospective cohort study examining relationships among epigenetic aging, brain injury, socioeconomic status, and neurodevelopment in infants born preterm. Investigators recruited 195 infants born at 24 to 32 weeks’ gestational age between 2015 and 2019; the supplied material does not report the study’s results. Prior research cited in the source links epigenetic age patterns and neonatal morbidities with neurodevelopmental measures, but their developmental significance remains uncertain.

Background

Preterm birth is associated with increased risk of developmental delay and cognitive, language, and motor impairments. Outcomes vary with clinical factors such as neonatal morbidities and brain injury, as well as environmental and home characteristics including socioeconomic status and parenting style. Epigenetic mechanisms, including DNA methylation, may reflect interactions between genes and environmental exposures; epigenetic clocks estimate biological age from methylation patterns. The pediatric buccal epigenetic (PedBE) clock has been validated in children born preterm, but the significance of epigenetic age acceleration or deceleration for development remains incompletely understood.

Data Highlights

Study characteristic	Reported information
Design	Prospective cohort
Recruitment period	2015–2019
Participants	195 infants born preterm
Gestational age	24–32 weeks
Recruitment sites	Neonatal intensive care units at two Canadian hospitals: The Hospital for Sick Children and Mount Sinai Hospital
Study focus	Relationships among epigenetic aging, brain injury, socioeconomic status, and neurodevelopmental outcomes

Key Findings

The study’s stated objective was to assess relationships between epigenetic aging, brain injury, socioeconomic status, and neurodevelopmental outcomes in a prospective cohort of preterm infants.
Investigators hypothesized that associations between epigenetic aging and neurodevelopmental outcomes would vary by extent of brain injury and maternal education.
Earlier research cited in the source found that epigenetic age acceleration was associated with higher cognitive and motor scores in children born preterm.
In the prior study described, neonatal morbidities were associated with epigenetic age deceleration; other cited studies reported epigenetic aging differences in children with bronchopulmonary dysplasia and postnatal infection.
The source identifies clinical, biological, and environmental factors—including sex, neonatal morbidities, brain injury, socioeconomic status, and parenting style—as relevant to variation in neurodevelopmental outcomes.
The supplied article excerpt does not include results from the 195-infant cohort, so its findings and effect estimates cannot be summarized.

Clinical Implications

The source describes neurodevelopment after preterm birth as reflecting interactions among biological, clinical, and environmental factors, while noting that the role of epigenetic aging remains incompletely understood. The American Academy of Pediatrics framework cited in the web research context supports risk-stratified longitudinal monitoring, collaboration with high-risk infant follow-up programs, and attention to social determinants of health.

Conclusion

The article frames epigenetic age as a potential correlate of neurodevelopmental variation in children born preterm and examines it alongside brain injury and socioeconomic factors. The provided material states the study design and hypothesis but does not provide cohort results.