Gestational age, birth weight, and risk for injuries in childhood
Yuelian Sun1, Paul Hsu, Mogens Vestergaard
1Department of Epidemiology, Institute of Public Health, University of Aarhus, Aarhus, Denmark. ys@soci.au.dk
Insights
Infants born with lower birth weight and earlier gestational age face a significantly higher risk of childhood injuries. Identifying these vulnerable newborns can aid in targeted injury prevention strategies.
Area of Science:
- Pediatric Injury Prevention
- Neonatal Health Outcomes
- Epidemiology
Background:
- Childhood injuries stem from various risk factors, yet neonatal characteristics like birth weight and gestational age are understudied.
- Previous research primarily focused on immediate causes of injury, overlooking early life determinants.
Purpose of the Study:
- To investigate the association between neonatal characteristics (birth weight, gestational age) and the risk of childhood injury.
- To determine if adverse neonatal conditions predict future injury hospitalizations.
Main Methods:
- A population-based cohort study included 1,524,114 singletons born in Denmark (1978-2004).
- Data on gestational age, birth weight, and injury hospitalizations were sourced from national registries.
- Poisson regression models estimated incidence rate ratios (IRR) for injury up to age 29.
Main Results:
- Decreasing gestational age and birth weight correlated with increased injury risk in the first 12 years of life.
- Children born preterm (20-32 weeks) had an IRR of 4.2 for injury compared to full-term infants (39-41 weeks).
- Low birth weight (<2000g) also significantly increased injury risk (IRR 4.0) even after adjusting for gestational age.
Conclusions:
- Adverse neonatal conditions are strongly linked to a substantially elevated risk of childhood injury.
- This highlights the potential for early identification of high-risk infants for targeted injury prevention programs.
- Further research is required to elucidate the specific causal pathways underlying these associations.
Background:
Some children experience more injuries than others due to personal or environmental risk factors, or to chance. Most injury studies have focused on proximal causes; few have examined the role of neonatal characteristics such as birth weight and gestational age.
Methods:
We carried out a population-based cohort study of 1,524,114 singletons born in Denmark between 1 January 1978 and 31 December 2004. We obtained information on gestational age, birth weight, and injury from the Danish Medical Birth Registry and the National Hospital Register. We followed participants up to age 29 years and estimated the incidence rate ratio (IRR) of hospitalization for injury, using Poisson regression models.
Results:
The risk of injury throughout childhood (mainly before 12 years of age) increased with decreasing gestational age and birth weight. The IRR of injury in the first 12 years of life was 4.2 (95% CI = 3.5-5.1), 2.3 (2.0-2.5), and 1.5 (1.3-1.6), respectively, for children born at gestational weeks 20-32, 33-36, and 37-38, compared with those born at gestational weeks 39-41. The IRR was 4.0 (3.4-4.6), 2.5 (2.1-2.8), and 1.4 (1.3-1.6) for children with a birth weight less than 2000 g, 2000-2499 g, and 2500-2999 g, compared with children of 3000-3999 g. Birth weight was also associated with increased risks of injury after adjusting for gestational age.
Conclusions:
Children born with adverse neonatal conditions have a marked increased risk of injury. This suggests an opportunity to identify children who may benefit from injury prevention. More research is needed to identify the causal pathways driving these associations.
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