Related Experiment Video
Updated: Jun 8, 2026
Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Gestational age and neurodevelopmental outcomes from 1 to 5 years: the PERSIAN birth cohort
Alireza Amin1, Shiva Maleki2, Motahar Heidari-Beni3
1Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Insights
Gestational age (GA) has minimal impact on child development and behavior across the full spectrum. Most associations are small, age-specific, and fade by preschool age, supporting cautious use in surveillance.
Area of Science:
- Pediatric developmental neuroscience
- Behavioral pediatrics
- Public health surveillance
Background:
- Gestational age (GA) is a potential factor in neurodevelopment and behavior.
- Limited evidence exists for the full preterm-to-post-term spectrum in community settings.
- Hypothesized small and age-specific associations between GA and outcomes.
Purpose of the Study:
- To investigate the association between gestational age and developmental/behavioral outcomes.
- To examine these associations across the entire preterm-to-post-term range.
- To inform the use of GA in developmental surveillance.
Main Methods:
- Secondary analysis of the PERSIAN Birth Cohort (n=3174).
- Gestational age examined continuously and categorically (preterm, early term, full term, late/post-term).
- Development assessed using Ages and Stages Questionnaire (ASQ) at 12 and 60 months; behavior using Child Behavior Checklist (CBCL) at 24 and 48 months; adjusted regression models used.
Main Results:
- Gestational age showed little association with ASQ total scores at 1 and 5 years.
- Small differences in CBCL total problem scores at 2 years were not apparent at 4 years.
- Modest, domain-specific differences (motor ASQ, some CBCL scales) were noted at 2 years, particularly in late/post-term children, attenuating by preschool age.
Conclusions:
- Gestational timing explained a small proportion of variation in developmental and behavioral screening outcomes.
- Findings support cautious, surveillance-oriented use of gestational age in pediatric practice.
- Most associations attenuated by preschool age, reducing concerns about broad persistent differences.
Background:
Gestational age (GA) may influence neurodevelopment and behavior, but evidence across the full preterm-to-post-term spectrum in community cohorts remains limited; we hypothesized that associations would be small and age-specific.
Methods:
We conducted a secondary analysis of the PERSIAN Birth Cohort (Isfahan, Iran; births 2016-2019). GA was examined continuously and in four categories (preterm, early term, full term, late/post-term). Development was assessed with the Ages and Stages Questionnaire (ASQ) at 12 and 60 months, and behavior with the Child Behavior Checklist (CBCL) at 24 and 48 months. Wave-specific regression models adjusted for maternal, perinatal, delivery, and socioeconomic factors.
Results:
Among 3174 children, GA showed little evidence of association with the ASQ total scores at 1 or 5 years and only small differences in the CBCL total problems scores at 2 years that were not apparent at 4 years. Secondary analyses suggested modest differences concentrated in motor-related ASQ domains and in a subset of CBCL syndrome and DSM-oriented scales at 2 years, particularly among late/post-term children, with most associations attenuated by preschool age.
Conclusion:
In this cohort, gestational timing explained a small proportion of variation in developmental and behavioral screening outcomes, supporting cautious use of gestational age in developmental surveillance.
Impact:
Across the full preterm-to-post-term spectrum, gestational age showed only modest, age- and domain-specific associations with developmental and behavioral screening outcomes. In a large community-based birth cohort, most associations attenuated by preschool age, reducing concern about broad persistent differences across early childhood. These findings support surveillance-oriented, context-aware use of gestational age in pediatric practice rather than deterministic risk labeling.
