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Pediatr Res. 2019 Apr 20. doi: 10.1038/s41390-019-0404-x. [Epub ahead of print]

Early life antecedents of positive child health among 10-year-old children born extremely preterm.

Author information

1
Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. jbangma@ad.unc.edu.
2
Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
3
School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
4
Department of Allied Health Sciences, University of North Carolina School of Medicine, Chapel Hill, NC, USA.
5
Department of Pediatrics, Boston Medical Center, Boston, MA, USA.
6
Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA.
7
Eunice Kennedy Shriver Center, Department of Psychiatry, University of Massachusetts Medical School/University of Massachusetts Memorial Health Care, Worcester, MA, USA.
8
Department of Pediatrics, Division of Pediatric Neurology, Boston University Medical Center, Boston, MA, USA.
9
Department of Pediatrics, University of North Carolina, Chapel Hill, NC, USA.
10
Department of Environmental Sciences and Engineering, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Abstract

BACKGROUND:

To identify modifiable antecedents during pre-pregnancy and pregnancy windows associated with a positive child health at 10 years of age.

METHODS:

Data on 889 children enrolled in the Extremely Low Gestational Age Newborn (ELGAN) study in 2002-2004 were analyzed for associations between potentially modifiable maternal antecedents during pre-pregnancy and pregnancy time windows and a previously described positive child health index (PCHI) score at 10 years of age. Stratification by race was also investigated for associations with investigated antecedents.

RESULTS:

Factors associated with higher PCHI (more positive health) included greater gestational age, birth weight, multiple gestation, and medical interventions, including assisted reproduction and cervical cerclage. Factors associated with lower PCHI included correlates of lower socioeconomic status, pre-pregnancy chronic medical disorders in the mother such as pre-pregnancy body mass index (BMI), and maternal asthma. When stratified by race, variation in significant results was observed.

CONCLUSIONS:

Among children born extremely preterm, medical interventions and higher socioeconomic status were associated with improved PCHI, while chronic illness and high BMI in the mother is associated with lower PCHI at 10 years of age. Knowledge of such antecedent factors could inform efforts to develop interventions that promote positive child health outcomes in future pregnancies.

PMID:
31005057
DOI:
10.1038/s41390-019-0404-x

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