Young adults born preterm have higher levels of cardiometabolic risk factors than their term-born peers. Muscular and cardiorespiratory fitness have important cardiometabolic and other health benefits. We assessed muscular, cardiorespiratory, and self-rated fitness in preterm-born young adults.


We studied unimpaired participants of the ESTER (Ennenaikainen syntymä ja aikuisiän terveys [Preterm Birth and Early-Life Programming of Adult Health and Disease]) birth cohort study at age 23.3 (SD: 1.2) years: 139 born early preterm (EPT; <34 weeks), 247 late preterm (LPT; 34–36 weeks), and 352 at term (control group). We measured muscular fitness with the number of modified push-ups performed in 40 seconds and maximal handgrip strength of the dominant hand, cardiovascular fitness with heart rate at the end of a 4-minute step test, and self-rated fitness. Data were analyzed with linear regression.


Young adults born EPT (−0.8; 95% confidence interval: −1.5 to −0.1; adjusted for gender, age, and source cohort) and LPT (−0.8; −1.4 to −0.3) performed fewer modified push-upsthan controls. Handgrip strength was 23.8 (0.9–46.8) N lower in EPT participants. Cardiorespiratory fitness, measured by submaximal step test, was similar. On a self-rated fitness scale (1–5), the EPT adults reported0.2 (0.0–0.4) lower scores than controls. After adjustment for early-life confounders, the results remained. They attenuated after further adjustment for mediating factors.


Young adults born EPT and LPT had lower muscular fitness than controls, which may predispose them to cardiometabolic and other chronic diseases. Adults born EPT also perceived themselves as less fit than controls.

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