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BJOG. 2015 Sep;122(10):1303-11. doi: 10.1111/1471-0528.13324. Epub 2015 Mar 6.

A whole-of-population study of term and post-term gestational age at birth and children's development.

Author information

1
School of Population Health, University of Adelaide, Adelaide, SA, Australia.
2
Pregnancy Outcome Unit, South Australian Department for Health and Ageing, Adelaide, SA, Australia.
3
Fraser Mustard Centre, Telethon Institute for Child Health Research, University of Western Australia, Adelaide, SA, Australia.
4
School of Social and Community Medicine, University of Bristol, Bristol, UK.

Abstract

OBJECTIVE:

To examine the risk of poor child development according to week of gestation at birth, among children born ≥ 37 weeks' gestation.

DESIGN:

Population-based study using linked data (n = 12,601).

SETTING:

South Australia.

POPULATION:

All births ≥ 37 weeks' gestation.

METHODS:

Relative risks of developmental vulnerability for each week of gestation were calculated with adjustment for confounders and addressing missing information.

MAIN OUTCOME MEASURES:

Child development was documented by teachers during a national census of children attending their first year of school in 2009, using the Australian Early Development Index (AEDI). Children scoring in the lowest 10% of the AEDI were categorised as developmentally vulnerable.

RESULTS:

The percentage of children vulnerable on one or more AEDI domains for the following gestational ages 37, 38, 39, 40, 41, 42-45 weeks was 24.8, 22.3, 20.6, 20.0, 20.4 and 24.2, respectively. Compared with children born at 40 weeks, the adjusted relative risks [(95% confidence interval (CI)] for vulnerability on ≥ 1 AEDI domain were; 37 weeks 1.13 (0.99-1.28), 38 weeks 1.05 (0.96-1.15), 39 weeks 1.02 (0.94-1.12), 41 weeks 1.00 (0.90-1.11) and 42-45 weeks 1.20 (0.84-1.72).

CONCLUSIONS:

Children born at 40-41 weeks' gestation may have the lowest risk of developmental vulnerability at school entry, reinforcing the importance of term birth in perinatal care. Early term or post-term gestational age at birth can help clinicians, teachers and parents recognise children with potential developmental vulnerabilities at school entry.

KEYWORDS:

Child development gestational age

PMID:
25754325
DOI:
10.1111/1471-0528.13324
[Indexed for MEDLINE]
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