Perinatal complications and aging indicators by midlife

Idan Shalev*, Avshalom Caspi, Antony Ambler, Daniel W. Belsky, Simon Chapple, Harvey Jay Cohen, Salomon Israel, Richie Poulton, Sandhya Ramrakha, Christine D. Rivera, Karen Sugden, Benjamin Williams, Dieter Wolke, Terrie E. Moffitt

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

49 Scopus citations


BACKGROUND: Perinatal complications predict increased risk for morbidity and early mortality. Evidence of perinatal programming of adult mortality raises the question of what mechanisms embed this long-term effect. We tested a hypothesis related to the theory of developmental origins of health and disease: that perinatal complications assessed at birth predict indicators of accelerated aging by midlife. METHODS: Perinatal complications, including both maternal and neonatal complications, were assessed in the Dunedin Multidisciplinary Health and Development Study cohort (N = 1037), a 38-year, prospective longitudinal study of a representative birth cohort. Two aging indicators were assessed at age 38 years, objectively by leukocyte telomere length (TL) and subjectively by perceived facial age. RESULTS: Perinatal complications predicted both leukocyte TL (β = -0.101; 95% confidence interval, -0.169 to -0.033; P = .004) and perceived age (β = 0.097; 95% confidence interval, 0.029 to 0.165; P = .005) by midlife. We repeated analyses with controls for measures of family history and social risk that could predispose to perinatal complications and accelerated aging, and for measures of poor health taken in between birth and the age-38 follow-up. These covariates attenuated, but did not fully explain the associations observed between perinatal complications and aging indicators. CONCLUSIONS: Our findings provide support for early-life developmental programming by linking newborns' perinatal complications to accelerated aging at midlife. We observed indications of accelerated aging "inside," as measured by leukocyte TL, an indicator of cellular aging, and "outside," as measured by perceived age, an indicator of declining tissue integrity. A better understanding of mechanisms underlying perinatal programming of adult aging is needed.

Original languageAmerican English
Pages (from-to)e1315-e1323
Issue number5
StatePublished - 1 Nov 2014
Externally publishedYes

Bibliographical note

Publisher Copyright:
Copyright © 2014 by the American Academy of Pediatrics.


  • Aging
  • Developmental programming
  • Perceived age
  • Perinatal complications
  • Telomere length


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