Early developmental outcomes predicted by gestational age from 35 to 41weeks
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Published on: August 25, 2014
Gwenden Dueker1, Jing Chen1, Candace Cowling2
1Department of Psychology, Grand Valley State University, Allendale, MI 49401, USA.
Insights
Even a few weeks early can impact a child's development. Each week of gestation past 35 weeks significantly lowers the risk of developmental delays in infants and toddlers.
Area of Science:
- Pediatric Development
- Neonatal Health
- Developmental Pediatrics
Background:
- Emerging evidence suggests preterm birth, even a few weeks early, is linked to increased health and cognitive issues.
- Previous understanding of risks associated with late preterm birth may have been underestimated.
Purpose of the Study:
- To determine if gestational age (GA) at birth (35-41 weeks) predicts developmental outcomes.
- To assess developmental screening scores at 8, 12, 20, and 24 months of age in relation to GA.
Main Methods:
- Analysis of archival developmental screening scores (Ages and Stage Questionnaires) from 2006-2012.
- Utilized negative binomial and logistic regression models.
- Included a large cohort of children (N=3319 at 8 months) assessed in a county-wide program.
Main Results:
- Each additional week of gestation from 35 to 41 weeks significantly reduced the overall risk of developmental delay at all assessed time points (8, 12, 20, 24 months).
- Gestational age specifically predicted reduced risk for delays in communication, personal-social skills, fine-motor abilities, and problem-solving.
- A graded, dose-response relationship was observed between increased gestational age and decreased risk for developmental delays.
Conclusions:
- A
- dose-response
- effect of gestational age on later development is evident, with each week past 35 weeks showing a graded decrease in overall and domain-specific developmental delay risks.
- Close monitoring of developmental outcomes is recommended for all children born before 40 weeks gestation.
Background:
Recent studies have indicated that children born only a few weeks earlier than their due date experience more health and cognitive problems than previously realized.
Aims:
Our study investigated whether gestational age (GA) at birth (35-41weeks) predicted developmental outcomes at 8, 12, 20, or 24months of age.
Study Design:
Archival records of developmental screening scores collected between 2006 and 2012 were analyzed using negative binomial and logistic regressions models.
Subjects:
Eight-month (N=3319), 12-month (N=2303), 20-month (N=1461) and 24-month (N=1222) old children were assessed in a county-wide developmental screening program.
Outcome Measures:
Ages and Stage Questionnaires (ASQs) scores.
Results:
After controlling for demographic covariates, from 35weeks of gestation on, each additional week of gestation (through 41) significantly reduced the overall risk for developmental delay at 8,12, 20 and 24-months of age. Gestational age also uniquely predicted specific risk for delay in the domains of communication, personal-social, fine-motor, and problem solving at various time-points during the first two years of life.
Conclusions:
With each additional week of gestation past 35weeks there was a graded decrease in the overall risk of developmental delay as well as in specific domains such as communication across the first two years of life. This evidence for the "dose-response" effect of GA on later development suggests that close monitoring of developmental outcomes for children born before 40weeks is warranted.
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