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Association of Gestational Age at Birth With Subsequent Suspected Developmental Coordination Disorder in Early
Jing Hua1, Anna L Barnett2, Gareth J Williams3
1Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China.
Insights
Children born at any degree of prematurity, early term, or post term face a higher risk of developmental coordination disorder (DCD). This highlights the need for monitoring motor development in these children.
Area of Science:
- Pediatrics
- Developmental Psychology
- Public Health
Background:
- Developmental Coordination Disorder (DCD) affects motor skills and can impact a child's development.
- The association between various gestational ages (preterm, early term, post term) and DCD risk is not fully understood.
- Understanding these risks is crucial for early identification and intervention.
Purpose of the Study:
- To investigate the association between different gestational ages at birth and the risk of suspected DCD.
- To analyze data from a large, representative sample of Chinese children.
- To provide insights into motor development disparities based on birth timing.
Main Methods:
- A retrospective cohort study involving 152,433 children aged 3-5 years in China.
- Gestational age categorized into 7 groups: very preterm, moderately preterm, late preterm, early term, full term, late term, and post term.
- Multilevel regression models used to assess the association between gestational age and suspected DCD, with parent-completed Little Developmental Coordination Disorder Questionnaire.
Main Results:
- Children born very preterm, moderately preterm, late preterm, early term, and post term showed a significantly higher likelihood of suspected DCD compared to full-term infants.
- Odds ratios ranged from 1.11 to 1.35 for these groups.
- No significant association was found for early-term and post-term births in 3-year-olds.
Conclusions:
- All degrees of prematurity, as well as early-term and post-term births, are associated with an increased risk of suspected DCD.
- These findings underscore the importance of considering gestational age in assessing motor development.
- Long-term follow-up and targeted interventions are recommended for children born outside the full-term range.
Importance:
It remains unknown whether children born at different degrees of prematurity, early term, and post term might have a higher risk of developmental coordination disorder (DCD) compared with completely full-term children (39-40 gestational weeks).
Objective:
To differentiate between suspected DCD in children with different gestational ages based on a national representative sample in China.
Design, Setting, And Participants:
A retrospective cohort study was conducted in China from April 1, 2018, to December 31, 2019. A total of 152 433 children aged 3 to 5 years from 2403 public kindergartens in 551 cities of China were included in the final analysis. A multilevel regression model was developed to determine the strength of association for different gestational ages associated with suspected DCD when considering kindergartens as clusters.
Main Outcomes And Measures:
Children's motor performance was assessed using the Little Developmental Coordination Disorder Questionnaire, completed by their parents. Gestational age was determined according to the mother's medical records and divided into 7 categories: completely full term (39 to 40 weeks' gestation), very preterm (<32 weeks), moderately preterm (32-33 weeks), late preterm (34-36 weeks), early term (37-38 weeks), late term (41 weeks), and post term (>41 weeks).
Results:
A total of 152 433 children aged 3 to 5 years (mean [SD] age, 4.5 [0.8] years), including 80 370 boys (52.7%) and 72 063 girls (47.3%), were included in the study. There were 45 052 children (29.6%) aged 3 years, 59 796 (39.2%) aged 4 years, and 47 585 (31.2%) aged 5 years. Children who were born very preterm (odds ratio [OR], 1.35; 95% CI, 1.23-1.48), moderately preterm (OR, 1.18; 95% CI, 1.02-1.36), late preterm (OR, 1.24; 95% CI, 1.16-1.32), early term (OR, 1.11; 95% CI, 1.06-1.16), and post term (OR, 1.17; 95% CI, 1.07-1.27) were more likely to be classified in the suspected DCD category on the Little Developmental Coordination Disorder Questionnaire than completely full-term children after adjusting for the same characteristics. Additionally, there was no association with suspected DCD in younger (aged 3 years) early-term and postterm children by stratified analyses.
Conclusions And Relevance:
In this cohort study, every degree of prematurity at birth, early-term birth, and postterm birth were associated with suspected DCD when compared with full-term birth. These findings have important implications for understanding motor development in children born at different gestational ages. Long-term follow-up and rehabilitation interventions should be considered for children born early and post term.
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