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Gestational Age at Birth and Risk of Developmental Delay: The Upstate KIDS Study
Kimberly A Hochstedler1, Griffith Bell2, Hyojun Park3
1Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan.
Insights
This study found that lower gestational age at birth is linked to increased risks of developmental delays in children up to age 3. Full-term deliveries at 40 weeks showed the lowest risk for developmental issues.
Area of Science:
- Pediatrics
- Developmental Biology
- Public Health
Background:
- Gestational age at birth is a critical factor influencing early child development.
- Developmental delays can have long-term impacts on a child's health and well-being.
- Early identification and intervention are crucial for children at risk.
Purpose of the Study:
- To model the association between gestational age at birth and early child development up to 3 years of age.
- To assess the risk of developmental delays and eligibility for early intervention services based on gestational age.
- To provide evidence for optimizing care for newborns of varying gestational ages.
Main Methods:
- Utilized data from 5,868 children in the Upstate KIDS study (New York, 2008-2014).
- Assessed child development at 7 time points using the Ages and Stages Questionnaire (ASQ), corrected for gestational age.
- Linked ASQ data with Early Intervention Program eligibility and adjusted for covariates like sociodemographics and maternal smoking.
Main Results:
- Children born at lower gestational ages (<32, 32-34, 35-36 weeks) had significantly higher odds of failing the ASQ compared to those born at 39 weeks.
- Deliveries at 40 weeks showed a lower risk of developmental delays (aOR=0.73) and eligibility for early intervention services (aOR=0.92) compared to 39 weeks.
- Gestational age was inversely associated with developmental delays across all assessed gestational ages.
Conclusions:
- Gestational age is a significant predictor of early child development and risk for developmental delays.
- Deliveries at 40 weeks demonstrate a protective effect against developmental delays compared to 39-week deliveries.
- Findings support the importance of considering gestational age in assessing developmental trajectories and guiding early intervention strategies.
Objective:
The aim of this study is to model the association between gestational age at birth and early child development through 3 years of age.
Study Design:
Development of 5,868 children in Upstate KIDS (New York State; 2008-2014) was assessed at 7 time points using the Ages and Stages Questionnaire (ASQ). The ASQ was implemented using gestational age corrected dates of birth at 4, 8, 12, 18, 24, 30, and 36 months. Whether children were eligible for developmental services from the Early Intervention Program was determined through linkage. Gestational age was based on vital records. Statistical models adjusted for covariates including sociodemographic factors, maternal smoking, and plurality.
Results:
Compared with gestational age of 39 weeks, adjusted odds ratios (aOR) and 95% confidence intervals of failing the ASQ for children delivered at <32, 32-34, 35-36, 37, 38, and 40 weeks of gestational age were 5.32 (3.42-8.28), 2.43 (1.60-3.69), 1.38 (1.00-1.90), 1.37 (0.98-1.90), 1.29 (0.99-1.67), 0.73 (0.55-0.96), and 0.51 (0.32-0.82). Similar risks of being eligible for Early Intervention Program services were observed (aOR: 4.19, 2.10, 1.29, 1.20, 1.01, 1.00 [ref], 0.92, and 0.78 respectively for <32, 32-34, 37, 38, 39 [ref], 40, and 41 weeks).
Conclusion:
Gestational age was inversely associated with developmental delays for all gestational ages. Evidence from our study is potentially informative for low-risk deliveries at 39 weeks, but it is notable that deliveries at 40 weeks exhibited further lower risk.
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