During pregnancy, women usually take all necessary precaution to ensure that they remain in good health and deliver healthy children at the recommended time.
But in some instances, for one reason or another, mothers may end up giving birth before their due date. Such deliveries are referred to as preterm births
The World Health Organisation (WHO) defines preterm births as babies born alive, before the recommended 37 weeks of pregnancy are completed.
A new study published in the journal of the European Association for the Study of Diabetes (Diabetologia) found that children born prematurely have an increased risk of developing diabetes (type 1 and 2) during their childhood or young adult life.
As such, the researchers note that affected children should therefore be monitored closely throughout their life, and sensitised on prevention efforts to lower their risk of the disease.
The research was the first large population-based study that examined risks of type 1 and type 2 diabetes in people born preterm.
It further looked at the potential differences between affected boys and girls from childhood into adulthood.
"This is important because doctors will increasingly encounter adults who were born prematurely due to higher survival rates and will need to understand their long-term risks," said Dr Casey Crump, an author of the study from the US-based Icahn School of Medicine at Mount Sinai.
The researchers note that medical records and history taking in patients of all ages should routinely include birth history, which encompasses gestational age, birth weight and any complications during or after the birth (such as preterm births).
Such information can help identify those born prematurely and facilitate screening and early preventive actions like counselling to promote lifestyle prevention of diabetes.
The study comprised of 4,193,069 single babies (not twins or other multiple births) born in Sweden between 1973 and 2014 who were followed up for type 1 and type 2 diabetes.
At the time of the research, the maximum and median age of the study population was 43 and 22 respectively.
The researchers also performed a co-sibling analysis (an assessment of the brothers or sisters of the people in the study).
Its goal was to provide more evidence as to whether the risk of diabetes was associated specifically with preterm birth, or linked to genetic and environmental factors shared by all siblings in a family.
The results showed that being born preterm was associated with a 21 percent increased risk of type 1 diabetes and a 26 percent enhanced chance of developing type 2 diabetes among study participants aged less than 18 years.
Among young adults aged between 18 and 43 years, a preterm birth was associated with a 24 percent and 49 percent risk of type 1 and type 2 diabetes respectively.
With regards to gender, the study found that males delivered prematurely had approximately 20 percent increased risk of type 1 diabetes in both age categories. For females, the increased risk was around 30 percent.
Across all the results, shared genetic and environmental factors between siblings were not wholly responsible for differences in diabetes risk in individuals born preterm.
Specifically, the authors highlight that the association between preterm birth and type 2 diabetes in those aged between 18 and 43 years appeared independent of shared familial factors.
The researchers note that the diabetes risk could be as a result of interrupted or insufficient production of beta cells in the pancreas of premature babies. The body relies on the insulin to regulate blood sugar.
In addition, the low immunity of premature babies and impact of medication or procedures they undergo while at the intensive care unit (ICU) during the birth period also makes them vulnerable to the disease.
"Because of major advances in treatment, most preterm infants now survive into adulthood. As a result, clinicians will increasingly encounter adult patients who were born prematurely,” note the researchers.
They state that preterm births should now be recognised as a chronic condition that predisposes those affected to the development of diabetes across in their life course.
Doctors currently seldom seek birth histories from adult patients, and thus preterm birth may remain a 'hidden' risk factor.
Other adverse effects linked to premature births include higher rates of disabilities such as cerebral palsy and even death.