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Neurodevelopmental risks of late-preterm and early-term births: a population-based study from Finland
Samson Nivins1, Mika Gissler2,3,4, Catharina Lavebratt3,5
1Department of Women's and Children's Health, karolinska Institutet, Stockholm, Sweden.
BMJ Public Health
|March 6, 2026
Summary
Late-preterm and early-term births increase the risk of neurodevelopmental disorders, including communication and motor issues. Longer gestation is linked to better developmental outcomes for children.
Area of Science:
- Neurodevelopmental disorders
- Perinatal health
- Child development
Background:
- Late-preterm and early-term births are recognized risk factors for neurodevelopmental disorders.
- Previous research has primarily focused on intellectual disabilities (ID), autism spectrum disorder (ASD), and attention-deficit/hyperactivity disorder (ADHD), neglecting communication and motor disorders.
- The influence of shared genetic and environmental factors versus direct effects of earlier birth on these outcomes remains unclear.
Purpose of the Study:
- To investigate the association between gestational age at birth and the risk of various neurodevelopmental disorders.
- To examine whether these associations are independent of shared familial factors.
Main Methods:
- A population-based cohort study of over 1 million singleton children born between 34 and 40 weeks of gestation in Finland (1996-2014).
- Follow-up for neurodevelopmental disorders until December 2021.
- Cox proportional hazards models and sibling-pair analyses were used to estimate risks and control for confounders.
Main Results:
- Prevalence of neurodevelopmental disorders decreased with increasing gestational age.
- Children born between 34+0 and 38+6 weeks gestation had a higher risk of communication disorders, motor disorders, and specific learning disorders compared to full-term births.
- These associations remained significant after adjusting for potential confounders, including shared familial factors. Risks for ID, ASD, and ADHD were also observed.
Conclusions:
- Late-preterm and early-term births are associated with increased risks of neurodevelopmental disorders, contrary to the perception of these groups being low-risk.
- The findings highlight the importance of considering gestational age in assessing neurodevelopmental risk.
- Promoting longer gestation may contribute to improved neurodevelopmental outcomes.
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