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Risk of developmental delay increases exponentially as gestational age of preterm infants decreases: a cohort study

Jorien M Kerstjens1, Andrea F de Winter, Inger F Bocca-Tjeertes

  • 1Division of Neonatology, Department of Pediatrics, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. j.m.kerstjens@umcg.nl

Developmental Medicine and Child Neurology
|October 2, 2012
PubMed

Insights

The risk of developmental delay in children increases exponentially as gestational age decreases below 36 weeks. This pattern affects all developmental domains, highlighting the impact of preterm birth on child development.

Area of Science:

  • Neonatalogy
  • Developmental Pediatrics
  • Public Health

Background:

  • Preterm birth is a significant risk factor for adverse child development.
  • Understanding the precise relationship between gestational age and developmental outcomes is crucial for early intervention.

Purpose of the Study:

  • To determine how decreasing gestational age influences the risk of developmental delay at age 4 years.
  • To analyze developmental delay across various domains in children born at a wide range of gestational ages.

Main Methods:

  • A community-based cohort study included 1439 preterm and 544 term-born children.
  • The Ages and Stages Questionnaire (ASQ) was completed by parents when children were aged 3 years 7 months to 4 years 1 month.
  • Prevalence rates of abnormal ASQ scores were compared across gestational age groups, with odds ratios adjusted for covariates.

Main Results:

  • Abnormal ASQ scores increased exponentially with decreasing gestational age, from 4.2% in term-born to 37.5% in infants born at 24-25 weeks.
  • The risk of developmental delay showed an exponential increase per week of gestation below 36 weeks (OR 1.14).
  • This exponential pattern was consistent across all ASQ developmental domains, even after covariate adjustment.

Conclusions:

  • Developmental delay risk escalates exponentially with decreasing gestational age below 36 weeks.
  • The findings underscore the significant impact of prematurity on all areas of child development.
  • Potential contributing factors include perinatal brain injuries and maturational disturbances.
Abstract

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