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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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A whole-of-population study of term and post-term gestational age at birth and children's development

L G Smithers1, A K Searle1, C R Chittleborough1

  • 1School of Population Health, University of Adelaide, Adelaide, SA, Australia.

BJOG : an International Journal of Obstetrics and Gynaecology
|March 11, 2015
PubMed

Insights

Children born at 40-41 weeks gestation have the lowest risk of developmental vulnerability. Early or late term births increase risks, highlighting the importance of full-term gestation for child development.

Area of Science:

  • Pediatric Development
  • Perinatal Health
  • Developmental Pediatrics

Background:

  • Child development at school entry is crucial for long-term outcomes.
  • Gestational age at birth is a known factor influencing infant health.
  • Understanding developmental risks associated with specific gestational ages is important for targeted interventions.

Purpose of the Study:

  • To investigate the association between week of gestation at birth and the risk of poor child development.
  • To identify optimal gestational ages for minimizing developmental vulnerability at school entry.

Main Methods:

  • A population-based study utilized linked data from 12,601 births in South Australia (≥ 37 weeks gestation).
  • Child development was assessed using the Australian Early Development Index (AEDI) in the first year of school (2009).
  • Developmental vulnerability was defined as scoring in the lowest 10% of AEDI domains; relative risks were calculated adjusting for confounders.

Main Results:

  • The percentage of children vulnerable on at least one AEDI domain was lowest for those born at 40 (20.0%) and 41 (20.4%) weeks gestation.
  • Compared to 40 weeks, adjusted relative risks for developmental vulnerability were 1.13 (95% CI 0.99-1.28) at 37 weeks and 1.20 (95% CI 0.84-1.72) at 42-45 weeks.
  • Children born at 38 and 39 weeks also showed slightly elevated risks compared to 40 weeks.

Conclusions:

  • Birth at 40-41 weeks gestation appears to be associated with the lowest risk of developmental vulnerability at school entry.
  • These findings underscore the significance of term birth in perinatal care.
  • Recognizing potential developmental vulnerabilities is aided by considering early-term or post-term gestational ages.
Abstract

Keywords:
Child development gestational age

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