The aim was to examine the relationship between gestational age and birthweight and adult chronic widespread pain (CWP).

Design and participants

A prospective cohort study of 18,558 participants recorded birthweight and gestation at birth.


Participants were categorised by gestation (fullterm ≥37 weeks; preterm <37 week) and birthweight (full birthweight (FBW) ≥2.5 kg; low birthweight (LBW) 1.5–2.5 kg; and very low birthweight (VLBW) <1.5 kg).


The presence or absence of CWP was measured by self-completed questionnaire in 8572 participants at age 45 yrs. Risk ratios were calculated using Poisson regression. Adjustment was made for potential confounding factors.


Premature birth was associated with a 26% increase in the risk of CWP compared to fullterm birth, although this was not statistically significant (risk ratio 1.26, 95% confidence interval 0.95–1.67). This increased risk was robust to adjustment for sex, social class at birth and age 42 yrs, or birthweight, but was completely attenuated when adjusted for childhood behavioural problems and adult psychiatric disorder.

LBW was not associated with an increased risk of CWP (RR 1.01, 95%CI 0.78–1.32). VLBW was associated with a non-significant increased risk (RR 1.48, 0.42–5.22) although there was insufficient study power to examine this relationship in the context of other factors.


Premature birth and VLBW are associated with increased risk of adult CWP although these effects are modest, and not statistically significant. Although not conclusive in itself, this study lends support to the theory that adult chronic pain may have its origins – at least in part – in very early life.