Children born prior to 39 weeks of pregnancy are more likely to encounter development issues in the first four to six years of life, according to a new study published in the journal Pediatrics.
For the study, researchers examined childhood development data from the 2009 and 2012 Australian Early Development Census. For the AEDC, teachers assessed students in their first year of full-time school across five domains: physical health, language and cognition, social competence, emotional maturity and general knowledge and communication. Students scoring in the bottom 10 percent of one of the domains were marked "developmentally vulnerable" and students scoring in the bottom 10 percent in two or more domains were considered "developmentally high risk." Reserchers matched the AEDC data with birth information on more than 150,000 children.
When compared to children birthed vaginally during spontaneous labor, the adjusted rate of being "developmentally high risk" was 26 percent higher for a planned birth at 37 weeks and 13 percent higher at 38 weeks. Among children born at 40 weeks of gestation, the adjusted relative risk of being "developmentally high risk" was 25 percent higher for children born at 32 to 33 weeks, 26 percent higher at 34 to 36 weeks, 17 percent higher at 37 weeks and 6 percent higher at 38 weeks. Researchers adjusted their assessments for other influencing factors known to affect childhood development like socioeconomic disadvantage, lower maternal age, maternal smoking in pregnancy and fetal growth restriction.
"While the association between being born earlier — lower gestational age — and poorer developmental outcomes is well established, our results revealed that poor development is further exacerbated in the case of planned birth, where a considered decision made to deliver an infant determines gestational age," said the study's lead author Natasha Nassar, PhD, an associate professor from the University of Sydney Menzies Centre for Health Policy in Australia. "In cases where labor occurs naturally before 39 weeks or planned birth is unavoidable, it is important that there are appropriate interventions and support in early childhood for these potentially vulnerable children."
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