Association of Gestational Age at Birth With Subsequent Neurodevelopment in Early Childhood: A National Retrospective Cohort Study in China
BackgroundThe association between preterm birth and neurodevelopmental delays have been well examined, however, reliable estimates for the full range of gestational age (GA) are limited, and few studies explored the impact of post-term birth on child development.ObjectiveThis study aimed to examine...
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Pediatrics |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fped.2022.860192/full |
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| author | Jing Hua Anna L. Barnett Yao Lin Hongyan Guan Yuanjie Sun Gareth J. Williams Yuxuan Fu Yingchun Zhou Wenchong Du |
| author_facet | Jing Hua Anna L. Barnett Yao Lin Hongyan Guan Yuanjie Sun Gareth J. Williams Yuxuan Fu Yingchun Zhou Wenchong Du |
| author_sort | Jing Hua |
| collection | DOAJ |
| description | BackgroundThe association between preterm birth and neurodevelopmental delays have been well examined, however, reliable estimates for the full range of gestational age (GA) are limited, and few studies explored the impact of post-term birth on child development.ObjectiveThis study aimed to examine the long-term neuropsychological outcomes of children born in a full range of GA with a national representative sample in China.MethodsIn this retrospective population-based cohort study, a total of 137,530 preschoolers aged 3–5 years old (65,295/47.5% females and 72,235/52.5% males) were included in the final analysis. The Ages and Stages Questionnaires-Third Edition (ASQ-3) was completed by parents to evaluate children's neurodevelopment. The associations between GA and neurodevelopment were analyzed by a generalized additive mixed model with thin plate regression splines. Logistic regression was also conducted to examine the differences in children's development with different GAs.ResultsThere was a non-linear relationship between GA and children's neurodevelopmental outcomes with the highest scores at 40 weeks gestational age. The adjusted risks of GAs (very and moderately preterm, late-preterm, early-term, and post-term groups) on suspected developmental delays were observed in communication (OR were 1.83, 1.28, 1.13, and 1.21 respectively, each p < 0.05), gross motor skill (OR were 1.67, 1.38, 1.10, and 1.05 respectively, each p < 0.05), and personal social behavior (OR were 1.01, 1.36, 1.12, and 1.18 respectively, each p < 0.05). The adjusted OR of very and moderately preterm, late-preterm, and early-term were observed in fine motor skills (OR were 1.53, 1.22, and 1.09 respectively, each p < 0.05) and problem-solving (OR were 1.33, 1.12, and 1.06 respectively, each p < 0.05).ConclusionGAs is a risk factor for neurodevelopmental delays in preschoolers after controlling for a wide range of covariates, and 40–41 weeks may be the ideal delivery GA for optimal neurodevelopmental outcomes. Close observation and monitoring should be considered for early- and post-term born children as well as pre-term children. |
| first_indexed | 2024-04-12T10:48:28Z |
| format | Article |
| id | doaj.art-dc57cfdd2fdf4d57bb5a33d52d2d806e |
| institution | Directory Open Access Journal |
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| language | English |
| last_indexed | 2024-04-12T10:48:28Z |
| publishDate | 2022-05-01 |
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| series | Frontiers in Pediatrics |
| spelling | doaj.art-dc57cfdd2fdf4d57bb5a33d52d2d806e2022-12-22T03:36:21ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602022-05-011010.3389/fped.2022.860192860192Association of Gestational Age at Birth With Subsequent Neurodevelopment in Early Childhood: A National Retrospective Cohort Study in ChinaJing Hua0Anna L. Barnett1Yao Lin2Hongyan Guan3Yuanjie Sun4Gareth J. Williams5Yuxuan Fu6Yingchun Zhou7Wenchong Du8Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, ChinaCentre for Psychological Research, Oxford Brookes University, Oxford, United KingdomHaikou Hospital of the Maternal and Child Health, Hainai, ChinaCapital Institute of Pediatrics, Beijing, ChinaShanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, ChinaSchool of Social Sciences, Nottingham Trent University, Nottingham, United KingdomKLATASDS-MOE, School of Statistics, East China Normal University, Shanghai, ChinaKLATASDS-MOE, School of Statistics, East China Normal University, Shanghai, ChinaNTU Psychology, Nottingham Trent University, Nottingham, United KingdomBackgroundThe association between preterm birth and neurodevelopmental delays have been well examined, however, reliable estimates for the full range of gestational age (GA) are limited, and few studies explored the impact of post-term birth on child development.ObjectiveThis study aimed to examine the long-term neuropsychological outcomes of children born in a full range of GA with a national representative sample in China.MethodsIn this retrospective population-based cohort study, a total of 137,530 preschoolers aged 3–5 years old (65,295/47.5% females and 72,235/52.5% males) were included in the final analysis. The Ages and Stages Questionnaires-Third Edition (ASQ-3) was completed by parents to evaluate children's neurodevelopment. The associations between GA and neurodevelopment were analyzed by a generalized additive mixed model with thin plate regression splines. Logistic regression was also conducted to examine the differences in children's development with different GAs.ResultsThere was a non-linear relationship between GA and children's neurodevelopmental outcomes with the highest scores at 40 weeks gestational age. The adjusted risks of GAs (very and moderately preterm, late-preterm, early-term, and post-term groups) on suspected developmental delays were observed in communication (OR were 1.83, 1.28, 1.13, and 1.21 respectively, each p < 0.05), gross motor skill (OR were 1.67, 1.38, 1.10, and 1.05 respectively, each p < 0.05), and personal social behavior (OR were 1.01, 1.36, 1.12, and 1.18 respectively, each p < 0.05). The adjusted OR of very and moderately preterm, late-preterm, and early-term were observed in fine motor skills (OR were 1.53, 1.22, and 1.09 respectively, each p < 0.05) and problem-solving (OR were 1.33, 1.12, and 1.06 respectively, each p < 0.05).ConclusionGAs is a risk factor for neurodevelopmental delays in preschoolers after controlling for a wide range of covariates, and 40–41 weeks may be the ideal delivery GA for optimal neurodevelopmental outcomes. Close observation and monitoring should be considered for early- and post-term born children as well as pre-term children.https://www.frontiersin.org/articles/10.3389/fped.2022.860192/fullgestational ageearly and post-term deliveryneurodevelopmentearly childhoodnational representative sample |
| spellingShingle | Jing Hua Anna L. Barnett Yao Lin Hongyan Guan Yuanjie Sun Gareth J. Williams Yuxuan Fu Yingchun Zhou Wenchong Du Association of Gestational Age at Birth With Subsequent Neurodevelopment in Early Childhood: A National Retrospective Cohort Study in China Frontiers in Pediatrics gestational age early and post-term delivery neurodevelopment early childhood national representative sample |
| title | Association of Gestational Age at Birth With Subsequent Neurodevelopment in Early Childhood: A National Retrospective Cohort Study in China |
| title_full | Association of Gestational Age at Birth With Subsequent Neurodevelopment in Early Childhood: A National Retrospective Cohort Study in China |
| title_fullStr | Association of Gestational Age at Birth With Subsequent Neurodevelopment in Early Childhood: A National Retrospective Cohort Study in China |
| title_full_unstemmed | Association of Gestational Age at Birth With Subsequent Neurodevelopment in Early Childhood: A National Retrospective Cohort Study in China |
| title_short | Association of Gestational Age at Birth With Subsequent Neurodevelopment in Early Childhood: A National Retrospective Cohort Study in China |
| title_sort | association of gestational age at birth with subsequent neurodevelopment in early childhood a national retrospective cohort study in china |
| topic | gestational age early and post-term delivery neurodevelopment early childhood national representative sample |
| url | https://www.frontiersin.org/articles/10.3389/fped.2022.860192/full |
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