ADHD and developmental speech/language disorders in late preterm, early term and term infants
N Z Rabie1, T M Bird2, E F Magann1
1Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
Insights
Late preterm and early term births are linked to increased risks of developmental speech and language delays. These long-term neurodevelopmental outcomes warrant consideration in delivery timing decisions.
Area of Science:
- Perinatal Medicine
- Neurodevelopmental Pediatrics
- Public Health
Background:
- Late preterm (34-36 weeks) and early term (37-38 weeks) births are increasing.
- Neurodevelopmental outcomes for these infants compared to full-term infants require further investigation.
- Maternal complications can influence infant neurodevelopmental outcomes.
Purpose of the Study:
- To compare long-term neurodevelopmental outcomes in late preterm, early term, and term infants.
- To control for maternal complications and comorbidities in the comparison.
- To identify specific neurodevelopmental risks associated with non-term gestations.
Main Methods:
- Retrospective cohort study using South Carolina Medicaid claims and vital records (2000-2003).
- Inclusion criteria: infants 1500-4500g, born 34 0/7 to 41 6/7 weeks, no congenital anomalies.
- Outcome measures: ICD-9-CM codes for ADHD and developmental speech/language disorders.
Main Results:
- 3270 late preterm, 11,527 early term, and 24,005 term infants met eligibility criteria.
- Elevated rates of outcome variables were observed in late preterm infants.
- Adjusted hazard ratios showed significant increased risk for developmental speech/language delay in both late preterm (AHR 1.36) and early term (AHR 1.27) infants.
Conclusions:
- Late preterm and early term deliveries are associated with adverse long-term neurodevelopmental outcomes.
- Developmental speech and language delays are significant risks for these infants.
- Findings should inform clinical decisions regarding the optimal timing of delivery.
Objective:
We sought to compare the long-term neurodevelopmental outcomes of late preterm, early term and term infants while controlling for a wide range of maternal complications and comorbidities.
Study Design:
Data for the study was obtained from the South Carolina Medicaid claims and vital records databases from 1 January 2000 to 31 December 2003. We included infants weighing between 1500 and 4500 g, born between 34 0/7 and 41 6/7 weeks, and with no congenital anomalies. Outcome measures were based on the presence of ICD-9-CM codes for attention deficit hyperactivity disorders and developmental speech or language disorders.
Result:
A total of 3270 late preterm (LPIs), 11,527 early term (ETIs) and 24,005 term infants met the eligibility criteria. Rates for all outcome variables were statistically significant and elevated for LPI, but adjusted hazard ratios (AHRs) were only significant for the risk of developmental speech and/or language delay (LPI: AHR 1.36 95% confidence interval (CI) 1.23 to 1.50; ETI: AHR 1.27 95% CI 1.17 to 1.37).
Conclusion:
Late preterm and early term deliveries have adverse long-term neurodevelopmental outcomes, and these outcomes should be considered when determining the timing of delivery.
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