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Published on: February 2, 2017
Gestational Age and Child Development at Age Five in a Population-Based Cohort of Australian Aboriginal and
Mark Hanly1, Kathleen Falster1,2,3, Georgina Chambers1,4
1Centre for Big Data Research in Health, UNSW Australia, Sydney, Australia.
Insights
Australian Aboriginal children face higher developmental vulnerability risks, especially preterm. Socio-economic factors largely explain these disparities, though the link between gestational age and development is similar across populations.
Area of Science:
- Child Development
- Public Health
- Perinatal Epidemiology
Background:
- Preterm birth and developmental vulnerability are disproportionately higher in Australian Aboriginal children compared to non-Aboriginal children.
- Understanding the relationship between gestational age and developmental outcomes is crucial for both populations.
Purpose of the Study:
- To quantify the association between gestational age and developmental vulnerability in Australian Aboriginal and non-Aboriginal children.
- To identify disparities in developmental outcomes based on Aboriginality and gestational age.
Main Methods:
- Linked perinatal datasets with the Australian Early Development Census (AEDC) for 97,989 children born in New South Wales.
- Assessed developmental vulnerability across five domains at age 5, analyzing risks by gestational age and Aboriginality.
Main Results:
- Aboriginal children had higher rates of preterm birth (9% vs. 5%) and developmental vulnerability (36% vs. 20%) compared to non-Aboriginal children.
- Developmental vulnerability decreased with increasing gestational age for all children.
- Aboriginal children exhibited higher risks of vulnerability across all gestational ages, particularly in the early term range.
Conclusions:
- The relationship between gestational age and developmental vulnerability is consistent between Aboriginal and non-Aboriginal children.
- Socio-economic disadvantage significantly contributes to the higher risk of developmental vulnerability observed in Aboriginal children.
- Targeted interventions addressing socio-economic factors are essential to reduce developmental disparities.
Background:
Preterm birth and developmental vulnerability are more common in Australian Aboriginal compared with non-Aboriginal children. We quantified how gestational age relates to developmental vulnerability in both populations.
Methods:
Perinatal datasets were linked to the Australian Early Development Census (AEDC), which collects data on five domains, including physical, social, emotional, language/cognitive, and general knowledge/communication development. We quantified the risk of developmental vulnerability on ≥1 domains at age 5, according to gestational age and Aboriginality, for 97 989 children born in New South Wales, Australia, who started school in 2009 or 2012.
Results:
Seven thousand and seventy-nine children (7%) were Aboriginal. Compared with non-Aboriginal children, Aboriginal children were more likely to be preterm (5% vs. 9%), and developmentally vulnerable on ≥1 domains (20% vs. 36%). Overall, the proportion of developmentally vulnerable children decreased with increasing gestational age, from 44% at ≤27 weeks to 20% at 40 weeks. Aboriginal children had higher risks than non-Aboriginal children across the gestational age range, peaking among early term children (risk difference [RD] 19.0, 95% confidence interval [CI] 16.3, 21.7; relative risk [RR] 1.91, 95% CI 1.77, 2.06). The relation of gestational age to developmental outcomes was the same in Aboriginal and non-Aboriginal children, and adjustment for socio-economic disadvantage attenuated the risk differences and risk ratios across the gestational age range.
Conclusions:
Although the relation of gestational age to developmental vulnerability was similar in Aboriginal and non-Aboriginal children, Aboriginal children had a higher risk of developmental vulnerability at all gestational ages, which was largely accounted for by socio-economic disadvantage.
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