Developmental Outcomes for Children After Elective Birth at 39 Weeks' Gestation

Area of Science:

• Obstetrics and Gynecology
• Developmental Pediatrics
• Public Health

Background:

• Elective births at 39 weeks gestation are rising, with potential benefits for maternal and perinatal outcomes.
• However, the long-term effects of elective birth on childhood development remain uncertain.

Purpose of the Study:

• To investigate the association between elective birth at 39 weeks gestation and the risk of childhood developmental vulnerability.
• To compare developmental outcomes between induction of labor and planned cesarean delivery for elective 39-week births.

Main Methods:

• A population-based cohort study using Australian statewide data from 2005-2013.
• Linked perinatal data to childhood developmental outcomes at ages 4-6 years using causal inference analyses.
• Defined developmental vulnerability as scoring below the 10th percentile in at least two of five developmental domains.

Main Results:

• Elective birth at 39 weeks gestation was not associated with increased childhood developmental vulnerability (aRR, 1.03; 95% CI, 0.96-1.12).
• No significant differences in developmental vulnerability were found between induction of labor and planned cesarean delivery for elective 39-week births (aRR, 0.96; 95% CI, 0.82-1.12).

Conclusions:

• Elective birth at 39 weeks gestation does not appear to increase the risk of childhood developmental vulnerability.
• Induction of labor and planned cesarean delivery at 39 weeks gestation yield similar long-term developmental outcomes for children.