Crump Casey
From the Department of Medicine, Stanford University, Palo Alto, CA.
J Am Board Fam Med. 2015 Jan-Feb;28(1):121-3. doi: 10.3122/jabfm.2015.01.130317.
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.
早产成年幸存者数量的迅速增长，首次使得对早产长期后果进行大规模调查成为必要且成为可能。大型流行病学研究表明，长期后遗症范围广泛，包括代谢紊乱、心血管和呼吸系统疾病、精神障碍以及死亡风险增加。临床医生现在应认识到早产是成年人的一种长期、多疾病风险因素。这些研究结果为越来越多关于慢性病早期生命编程的证据做出了贡献，这反过来又支持了一种用于患者护理的“生命历程”范式。家庭医学因其在照顾患者整个生命周期中的独特作用，是这种范式理想的学科。随着我们对早期生命对长期健康影响的理解不断推进，家庭医生处于将这一知识纳入临床实践的理想位置。
