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Teens Born Before 28 Weeks of Pregnancy Report Positive Well-Being During the COVID-19 Pandemic
Authors: Elisabeth McGowan, et al.
Who sponsored this study?
The Environmental influences on Child Health Outcomes (ECHO) Program, Office of the Director, National Institutes of Health supported this research.
Why was this study needed?
The COVID-19 pandemic disrupted children’s daily lives, schooling, social connections, and family routines in ways that may have affected their mental health and overall well-being. Teens who were born before 28 weeks of pregnancy, which is considered extremely preterm birth, are often thought to be at higher risk for health and developmental challenges. Prior studies found that many people who were born early say their quality of life is about the same as people born at full term. Less is understood about how teens born preterm feel about their health and well-being during the major stress and disruptions of the pandemic. ECHO researchers wanted to understand whether teens born early experienced the pandemic differently than their peers and whether they showed signs of resilience during this challenging time.
What were the study results?
During the COVID-19 pandemic, adolescents born extremely preterm reported overall health similar to adolescents born at term. After accounting for key demographic factors, they also reported higher life satisfaction and a stronger sense of meaning and purpose. Adolescents born moderately (born at 28-33 weeks) or late preterm (born at 34-36 weeks) did not differ meaningfully from those born at term. These findings suggest that, in this study, adolescents born extremely preterm showed signs of positive well-being during a difficult period.
What was the study's impact?
This study highlights that adolescents born extremely preterm may have strengths and resilience that are not captured by focusing only on medical risks or challenges. These findings challenge assumptions that children born very early will report worse well-being and highlight the importance of asking young people directly how they view their own health and lives.
Who was involved?
Participants included 4,093 biological mother and child pairs from 38 ECHO Cohort Study Sites across the United States, including adolescents born preterm (less than 37 weeks) and adolescents born at term (more than 37 weeks). The children, ages 10–18 years, had data about how far along the pregnancy was when they were born and at least one self-reported survey on well-being collected between March 2020 and March 2023.
What happened during the study?
Researchers used ECHO Cohort data to compare positive health outcomes reported by adolescents based on how early or full-term they were born. Adolescents completed validated PROMIS questionnaires (Pediatric Global Health, Life Satisfaction, and Meaning and Purpose) during the pandemic period (March 2020–March 2023).
Footnote: Results reported here are for a single study. Other or future studies may provide new information or different results. You should not make changes to your health without first consulting your healthcare professional.
What happens next?
Future research could help researchers explore why teens born extremely early may report better well-being by looking at things like ongoing health challenges, depression or anxiety, and the support they receive at home, at school, and in their communities.
Where can I learn more?
Access the full journal article, titled “Self-reported Positive Health Outcomes During the COVID-19 Pandemic Among Adolescents Born Preterm in the ECHO Cohort,” in the Journal of Perinatology.
The content is the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Published April 27, 2026