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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Population impact of preterm birth and low birth weight on developmental disabilities in US children
Laura A Schieve1, Lin H Tian1, Kristin Rankin2
1National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.
Insights
Preterm birth significantly impacts child neurodevelopment, with varying effects across different developmental disabilities (DDs). Understanding these population impacts is crucial for public health initiatives.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Public Health
Background:
- Previous research indicates links between adverse perinatal outcomes and developmental disabilities (DDs).
- However, the population-level impact of these associations remains understudied.
- Understanding these impacts is vital for effective public health strategies and interventions.
Purpose of the Study:
- To quantify the population attributable fractions (PAFs) for associations between birth weight categories and neurodevelopmental outcomes.
- To assess the adjusted relative risks (aRRs) for various developmental disabilities in children aged 3-17 years.
- To determine the population impact of preterm birth and/or low birth weight on specific neurodevelopmental conditions.
Main Methods:
- Utilized data from the 2011-2012 National Survey of Children's Health.
- Calculated adjusted relative risks (aRRs) for associations between birth weight (VLBW, MLBW, NBW) and preterm status with seven DDs.
- Computed population attributable fractions (PAFs) to estimate the population-level impact of these risk factors.
Main Results:
- Strong associations were found between preterm birth and cerebral palsy (CP), intellectual disability (ID), and autism spectrum disorder (ASD).
- Population attributable fractions were highest for CP (55%), followed by ID, ASD, and learning disability (LD) (10%-20%).
- Attention-deficit-hyperactivity disorder (ADHD) and behavioral-conduct disorders had a lower population impact (<5%).
Conclusions:
- Preterm birth significantly influences child neurodevelopment across various conditions.
- The relative associations and population impacts differ substantially depending on the specific developmental disability.
- These findings underscore the importance of addressing perinatal factors to mitigate the burden of neurodevelopmental disorders.
Purpose:
Although previous studies demonstrate associations between adverse perinatal outcomes and developmental disabilities (DDs), study of population impacts is limited.
Methods:
We computed relative risks adjusted (aRRs) for sociodemographic factors and component and summary population attributable fractions (PAFs) for associations between very low birth weight (VLBW, all preterm births), moderately low birth weight (MLBW) + Preterm, MLBW at term, and normal birth weight (NBW) + Preterm and seven DDs (cerebral palsy [CP], autism spectrum disorder [ASD], intellectual disability [ID], behavioral-conduct disorders, attention-deficit-hyperactivity disorder [ADHD], learning disability [LD], and other developmental delay) among children aged 3-17 years in the 2011-2012 National Survey of Children's Health.
Results:
VLBW-Preterm, MLBW-Preterm and NBW-Preterm were strongly to moderately associated with CP (aRRs: 43.5, 10.1, and 2.2, respectively; all significant) and also associated with ID, ASD, LD, and other developmental delay (aRR ranges: VLBW-Preterm 2.8-5.3; MLBW-Preterm 1.9-2.8; and NBW-Preterm 1.6-2.3). Summary PAFs for preterm birth and/or LBW were 55% for CP, 10%-20% for ASD, ID, LD, and other developmental delay, and less than 5% for ADHD and behavioral-conduct disorders. Findings were similar whether we assessed DDs as independent outcomes or within mutually exclusive categories accounting for DD co-occurrence.
Conclusions:
Preterm birth has a sizable impact on child neurodevelopment. However, relative associations and population impacts vary widely by DD type.
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