Children Born Moderately or Late Preterm Have Higher Long-Term Risks of Neurodevelopmental Difficulties

Children Born Moderately or Late Preterm Have Higher Long-Term Risks of Neurodevelopmental Difficulties

A recent study published in The BMJ reveals that children born moderately (32-33 weeks) or late preterm (34-36 weeks) face increased long-term risks of neurodevelopmental difficulties that can impact their behavior and learning abilities. The study, which examined over one million children, emphasizes that these risks should not be overlooked, as children born at these gestational ages constitute approximately 80% of all preterm births.

While previous research has highlighted the higher incidence of neurodevelopmental and behavioral disabilities in early-born children during their first years, childhood, and adolescence, there remains a knowledge gap regarding the long-term outcomes of moderately and late preterm children compared to those born at full term.

To address this gap, researchers analyzed data from the Swedish national registry and focused on the neurodevelopmental outcomes of children born at different gestational ages, particularly 32-33 weeks and 34-36 weeks, in comparison to those born at 39-40 weeks (full term). The study included 1,281,690 singleton children without birth defects, born in Sweden between 1998 and 2012, and also considered a subgroup of 349,108 full siblings to control for shared genetic and environmental factors.

The study accounted for various potential influencing factors, such as maternal age, parity, country of birth, cohabiting status, body mass index during early pregnancy, smoking and medical history of the mother, calendar period of delivery, parents’ educational level and history of neurological and psychiatric disorders, as well as the infant’s sex and birth weight for gestational age.

Over an average follow-up period of 13 years, the researchers found that 75,311 infants (48 per 10,000 person years) received a diagnosis of some form of neurodevelopmental impairment. Specifically, 5,899 (4 per 10,000) had motor impairment, 27,371 (17 per 10,000) had cognitive impairment, 11,870 (7 per 10,000) had epileptic impairment, 19,700 (12 per 10,000) had visual impairment, and 20,393 (13 per 10,000) had hearing impairment.

Comparing the children born moderately or late preterm to those born full term, the study found higher risks for any impairment. For example, there were an additional 475 cases of impairment per 10,000 population by the age of 16 years for children born moderately preterm compared to those born full term.

The study also noted that the highest relative risk for children born moderately preterm was for motor impairment, with an almost five-fold increased risk, followed by epileptic impairment, with a nearly two-fold increased risk. Risks for neurodevelopmental impairments were highest from 32 weeks of gestation, gradually declining until 41 weeks, and were higher at early term (37-38 weeks) than at full term.

While this observational study cannot establish causality, it highlights the importance of considering these risks and providing appropriate follow-up care for children born moderately or late preterm. The researchers emphasize that healthcare professionals and families can use these findings to better assess and plan for the care of children in this population.

An FAQ section based on the main topics and information presented in the article:

1. What does the recent study published in The BMJ reveal?
The study reveals that children born moderately (32-33 weeks) or late preterm (34-36 weeks) face increased long-term risks of neurodevelopmental difficulties that can impact their behavior and learning abilities.

2. What is the significance of this study?
This study is important because children born at gestational ages of 32-36 weeks constitute approximately 80% of all preterm births, and there is a knowledge gap regarding their long-term outcomes compared to those born at full term.

3. What data did the researchers analyze?
The researchers analyzed data from the Swedish national registry, including 1,281,690 singleton children without birth defects born between 1998 and 2012. They also considered a subgroup of 349,108 full siblings to control for shared genetic and environmental factors.

4. What factors did the study account for?
The study accounted for various potential influencing factors such as maternal age, parity, country of birth, cohabiting status, maternal body mass index during early pregnancy, smoking and medical history, calendar period of delivery, parents’ educational level and history of neurological and psychiatric disorders, as well as the infant’s sex and birth weight for gestational age.

5. What were the findings of the study?
Over an average follow-up period of 13 years, the researchers found that children born moderately or late preterm had higher risks for any impairment compared to those born full term. The highest relative risk for children born moderately preterm was motor impairment, followed by epileptic impairment. Risks for neurodevelopmental impairments were highest from 32 weeks gestation, declining until 41 weeks.

6. What were the specific impairments identified in the study?
The study identified various impairments including motor impairment, cognitive impairment, epileptic impairment, visual impairment, and hearing impairment.

7. What are the implications of the study?
Although the study cannot establish causality, it highlights the importance of considering the risks and providing appropriate follow-up care for children born moderately or late preterm. Healthcare professionals and families can use these findings to better assess and plan for the care of these children.

Definitions for key terms or jargon used within the article:

1. Neurodevelopmental difficulties: Difficulties relating to the development of the nervous system, which can impact behavior and learning abilities.
2. Preterm birth: Birth that occurs before the completion of 37 weeks of gestation.
3. Singleton: Referring to an individual born as the only offspring.
4. Observational study: A study in which researchers observe subjects and collect data without intervening or manipulating any variables. Causality cannot be established in observational studies.

Suggested related links:

1. The BMJ
2. CDC – Preterm Births
3. WHO – Preterm Births

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