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In the field of neonatal care, every milestone reached by a preterm infant is a victory. But as cutting-edge research conducted by University of Rhode Island (URI) nursing Associate Professor Amy D’Agata shows, the story doesn’t end with survival. D’Agata, a neonatal intensive care nurse turned researcher, is spearheading a unique longitudinal study. As the only nurse-led study of its kind in the world, this multi-decade study examines the long-term health outcomes of individuals born preterm. Babies born preterm must be supported through the early stages of their life using various technologies and medications. Despite the challenges, the survival rate for preterm infants in the developed world is high, which is why D’Agata has turned her focus instead to the potential lifelong complications that preterm birth might pose. “We have the technology to support survival in these very early weeks,” she says. “So now we should be placing more emphasis on quality of life for those born preterm as they age.” The study D’Agata leads originated at Brown University and then as a collaboration between Brown and URI. She took the reins from now-retired URI Professor Mary Sullivan in 2022. This research has tracked a cohort of 160 individuals born preterm during the course of three decades and will continue to track them throughout their life, comparing them to a group of individuals born full-term. While there is a lot of research around infancy and early childhood as it relates to those born preterm, much less is known about how being born preterm can affect people as they age. “Ideally, if we analyze how preterm birth can affect later-in-life outcomes, we can then work towards interventions that interrupt disease development, contributing to meaningful health outcomes in new and different ways,” D’Agata says. While the initial focus of the study was rooted in developmental psychology, the current study has expanded its scope to include physiological health as the cohort ages. “We’re looking at cardiovascular, endocrine, metabolic, and epigenetic factors,” she explains. “We’re hoping to understand what health differences might exist between preterm and full term born adults and consider what intervention might be needed now, as well what we could do earlier in life to improve their health as they grow up.” To date, the research has shown that the preterm group had higher blood pressure as young adults in their 20s than the full-term group, as well as dysregulation in their hypothalamus pituitary-adrenal axis. It is possible that early life experience of being born preterm impacts how they subsequently respond to

With each milestone achieved and insight gained, D’Agata’s research shines a light on the frontiers of neonatal care— bringing URI to the forefront of the innovative field.

AMY D’AGATA Associate Professor Nursing

goals and spirit of the study, while looking to the future. With each milestone achieved and insight gained, D’Agata’s research shines a light on the frontiers of neonatal care—bringing URI to the forefront of the innovative field. “This is a unique study,” says D’Agata. “We have more URI faculty collaborators involved than ever before, and I am so excited about having a team from our University that can contribute to this important research.”

stress. The current study will help to determine how prematurity and environmental stress effect preterm-to- adult health. Previously, the study conducted projects examining outcomes of the cohort at birth, infancy, four years, eight years, 17 years, and 23 years of age. COVID-19 caused a brief delay, and the cohort members are now in their mid-30s, which presents new challenges and opportunities for research.

D’Agata stresses the need to engage participants and retain their involvement in the study. Findings have far-reaching implications that contribute valuable insights to the field of neonatal care. By analyzing the data collected over decades, she and her team aim to draw connections and inform interventions for the next phase of the study.

D’Agata remains committed to upholding the original

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