TOPLINE

Many adults born very preterm (VP) or with very low birth weight (VLBW) showed optimal functioning at 34 years of age across domains such as wealth and social relationships. Higher intelligence quotient (IQ) during childhood was associated with reduced odds of struggling with economic and social issues.

METHODOLOGY

• Positive functioning refers to the factors that help people succeed and do well in life and has been recognized as a health indicator.
• Researchers conducted a longitudinal cohort study in Germany following 416 adults (52.2% women) from birth (between 1985 and 1986) to identify positive functioning profiles at age 34.
• Among these, 214 adults were born VP or with VLBW, and 202 healthy term-born children born around the same time were considered as control individuals.
• Adults were assessed for positive functioning across risk avoidance, wealth, and social relationship domains using a standard life course interview, and satisfaction with life was also evaluated.
• Various childhood factors were examined, including VP or VLBW status at birth, effortful control and IQ at the age of 8, parental warmth and parental quality at the ages of 6 and 8, the quality of peer relationships at the age of 8, socioeconomic status of the family at birth, and the quality of the relationship between parents at the age of 8.

TAKEAWAY

• Three functioning profiles were identified: optimal (63%), moderate (26%), and low economic and social (12%), with varying scores noted in relationship, wealth, and risk-avoidance domains.
• The proportion of individuals born VP or with VLBW was higher among those with low economic and social functioning profiles (93%) than in those with optimal functioning profiles (44%).
• Adults with optimal functioning profiles had significantly higher mean life satisfaction scores than those with moderate functioning and low economic and social functioning profiles.
• A higher childhood IQ was associated with lower odds of low economic and social functioning compared with optimal functioning (adjusted odds ratio [aOR], 0.21; 95% CI, 0.13-0.34) and moderate functioning (aOR, 0.33; 95% CI, 0.20-0.55).

IN PRACTICE

“Childhood cognitive abilities emerged as an important long-term influence, highlighting pathways of supporting functioning well into adulthood,” the researchers of the study wrote.

SOURCE

The study was led by Elif Gönen, PhD, of the Department of Psychology at the University of Warwick in Coventry, England. It was published online on July 20, 2026, in JAMA Pediatrics.

LIMITATIONS

Less than 60% of eligible adults were assessed at 34 years of age. The cohort was limited to adults born in the mid-1980s in one region of Germany.

DISCLOSURES

Data collection for the study was funded by the German Federal Ministry of Education and Science and the European Commission Horizon 2020 as part of the RECAP Consortium. Several authors reported receiving fellowship grants. One author reported receiving grants from the UK Research and Innovation’s Engineering and Physical Sciences Research Council during the conduct of the study.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.