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Gestational age at term delivery and children's neurocognitive development

Jessica L Gleason1, Stephen E Gilman2,3, Rajeshwari Sundaram4

  • 1Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.

International Journal of Epidemiology
|January 9, 2022
PubMed

Insights

Full-term birth at 40-41 weeks gestation is linked to better neurocognitive outcomes. Delivering earlier, even at 37-39 weeks, is associated with lower developmental scores in children.

Area of Science:

  • Neuroscience
  • Developmental Pediatrics
  • Public Health

Background:

  • Preterm birth is known to impact neurocognitive performance.
  • The neurodevelopmental benefits of extending gestation within the full-term range (37-41 weeks) remain unclear.
  • Understanding these differences is crucial given high rates of obstetric intervention in the USA.

Purpose of the Study:

  • To investigate the association between gestational age at term (37-41 weeks) and neurocognitive development.
  • To determine if neurodevelopmental outcomes improve with each additional week of gestation within the full-term range.

Main Methods:

  • Secondary analysis of 39,199 singleton births from the US Collaborative Perinatal Project (1959-1976).
  • Neurodevelopmental assessments at 8 months (Bayley Scales), 4 years (Stanford-Binet IQ), and 7 years (WISC, WRAT).
  • Evaluated outcomes across each week of term gestation (37-41 weeks).

Main Results:

  • Neurocognitive performance improved progressively with each week of gestation from 37 to 40-41 weeks.
  • Children born at 37 and 38 weeks showed lower scores across most assessments compared to those born at 40 weeks.
  • Birth at 39 weeks was associated with lower Bayley Mental and Psychomotor scores, and in sibling analyses, lower Wide-Range Achievement Test scores.

Conclusions:

  • Each week of gestation up to 40-41 weeks is vital for optimal short- and long-term cognitive development.
  • The 40-41 week gestational window appears to be ideal for maximizing neurodevelopmental outcomes.
  • Findings support optimizing delivery timing for improved child neurodevelopment.
Abstract

Keywords:
Neurocognitive developmentchild developmentobstetricsterm delivery

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