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Mild prematurity, proximal social processes, and development

Hilary K Brown1, Kathy Nixon Speechley2, Jennifer Macnab3

  • 1Departments of Epidemiology and Biostatistics, Karen.Campbell@schulich.uwo.ca.

Pediatrics
|August 13, 2014
PubMed

Insights

Gestational age is not the primary driver of developmental outcomes in children born late preterm or early term. Social factors, such as parenting, play a more significant role in child development closer to full term.

Area of Science:

  • Pediatric developmental outcomes
  • Perinatal research
  • Social determinants of health

Background:

  • Late preterm (34-36 weeks) and early term (37-38 weeks) births are increasing globally.
  • Previous research suggests potential risks associated with these birth categories compared to full term (39-41 weeks).
  • The influence of gestational age versus social factors on developmental trajectories requires further elucidation.

Purpose of the Study:

  • To investigate the association between gestational age (late preterm, early term, full term) and developmental outcomes in children.
  • To examine the role of proximal social processes, specifically parenting, in moderating this association.
  • To determine the relative contributions of gestational age and social factors to developmental outcomes.

Main Methods:

  • Analysis of the Canadian National Longitudinal Survey of Children and Youth data.
  • Inclusion of singletons born between 34 and 41 weeks gestational age.
  • Utilized multivariable modified Poisson regression to estimate adjusted relative risks (aRRs) for developmental outcomes at 2-3 and 4-5 years.
  • Employed moderation analyses to assess the impact of parenting.

Main Results:

  • Unadjusted analyses indicated a higher risk of developmental delay for late preterm births.
  • Adjusted analyses showed no significant differences in developmental outcomes between late preterm, early term, and full-term infants at 2-3 or 4-5 years.
  • Parenting significantly predicted developmental outcomes but did not moderate the effect of gestational age.

Conclusions:

  • Gestational age within the late preterm and early term ranges does not appear to be a significant independent predictor of developmental outcomes when adjusted for social factors.
  • Social factors, particularly parenting, are crucial influences on child development, especially for those born closer to full term.
  • Future interventions should focus on social support and parenting to optimize developmental trajectories.
Abstract

Keywords:
child developmentparentingpreterm birth

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