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Neurodevelopmental outcomes at age 3 years after moderate preterm, late preterm and early term birth: the Japan

Katsuya Hirata1, Kimiko Ueda2,3, Kazuko Wada4

  • 1Department of Neonatal Medicine, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan khirata0513@gmail.com.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|September 14, 2023
PubMed

Insights

Children born moderately preterm, late preterm, or early term face increased risks of neurodevelopmental impairments by age 3. Early detection and intervention are crucial for these infants.

Area of Science:

  • Pediatrics
  • Developmental Neuroscience
  • Public Health

Background:

  • Gestational age at birth is a critical factor influencing infant development.
  • Preterm and early term births are associated with potential long-term health and developmental challenges.
  • Understanding the specific risks across different gestational age categories is vital for targeted interventions.

Purpose of the Study:

  • To evaluate the association between gestational age at birth and the risk of neurodevelopmental impairments (NDIs) at 3 years of age.
  • To compare the risk of NDIs in moderate preterm, late preterm, and early term infants versus full-term infants.
  • To identify specific developmental domains affected by varying degrees of prematurity.

Main Methods:

  • A large cohort study utilizing the Japan Environment and Children's Study database.
  • Inclusion of 86,138 singleton children born between 32-41 weeks gestation without congenital abnormalities.
  • Neurodevelopmental impairment assessed at age 3 using the Ages and Stages Questionnaire (ASQ-3); logistic regression analysis adjusted for confounders.

Main Results:

  • Moderate preterm, late preterm, and early term births were all associated with increased odds of NDIs compared to full-term births.
  • Specific risks were observed across multiple developmental domains, including communication, gross motor, fine motor, problem-solving, and personal-social skills.
  • The risk of NDIs generally increased with greater prematurity, with moderate preterm infants showing the highest adjusted odds ratios across most domains.

Conclusions:

  • Births at moderate preterm, late preterm, and early term gestational ages are linked to a higher risk of neurodevelopmental impairment by age 3.
  • The risk escalates with increasing prematurity, highlighting the vulnerability of these infants.
  • Close monitoring and timely intervention by healthcare professionals are essential for children born before full term to mitigate developmental deficits.
Abstract

Keywords:
child developmentepidemiologyinfant developmentneonatologypaediatrics

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