Subtle adverse effects of late preterm birth: a cautionary note

Area of Science:

• Neuroscience
• Developmental Psychology
• Obstetrics

Background:

• Late preterm birth (35-36 weeks) is associated with short-term health issues, but long-term psychological effects are not well understood.
• Early elective delivery is common, with the assumption of no lasting adverse outcomes.
• Uncertainty exists regarding potential psychological risks emerging in early childhood.

Purpose of the Study:

• To investigate intellectual, neuropsychological, and behavioral outcomes at age 3 years in late preterm infants compared to term infants.
• To determine if neonatal intensive care unit (NICU) admission influences these outcomes.
• To identify the role of gestational age versus neonatal medical factors in developmental outcomes.

Main Methods:

• Comparative study of 278 late preterm (35-36 weeks) and 192 term (37-41 weeks) children at age 3.
• Utilized analysis of variance, analysis of covariance, and regression analyses for outcome assessment.
• Included an additional 132 participants born at 34 weeks gestation.

Main Results:

• Late preterm children exhibited lower general conceptual ability (GCA/IQ), and deficits in verbal, nonverbal, spatial, visuomotor, and dexterity skills.
• Poorer adaptability was observed in late preterm children compared to term peers (p < .01).
• Gestational age was the primary predictor of outcomes; neonatal medical variables and NICU admission status did not significantly impact results.

Conclusions:

• Gestational age is a critical developmental continuum that should not be interrupted without medical necessity.
• Subtle but significant developmental effects observed in late preterm children have implications for obstetric practice.
• Data supports informed parental decision-making regarding early elective delivery, emphasizing the absence of maternal or fetal indications.