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Born a bit too early: A study of early planned birth and child development at school age
- Source :
- International Journal of Population Data Science. 1
- Publication Year :
- 2017
- Publisher :
- Swansea University, 2017.
-
Abstract
- ObjectivesFetal growth and development is a continuum with the optimal time of birth at 39-40 weeks gestation. Internationally, significant changes in clinical practice have seen planned birth (labour induction or pre­labour caesarean section) before 40 completed weeks gestation increase. Fetal brain development accelerates rapidly in the later stages of pregnancy from 32 weeks gestation, making it vulnerable to disruption from even slightly shortened gestation. This study aimed to investigate the association of gestational age and mode of birth with early childhood development. ApproachThis study utilised a population-based record-linkage of administrative birth, hospital and development data to obtain a cohort of 153,730 live born infants in New South Wales, Australia. These infants were born between 2002 and 2007, with a gestational age of at least 32 weeks and had an early development assessment in their first year of school in 2009 or 2012. Childhood development was assessed in five main domains (physical health and wellbeing, language and cognitive skills, social competence, emotional maturity, and communication skills and general knowledge) with each comprised of a number of sub-domains. Children with a score below the 10th percentile nationally are considered developmentally vulnerable (DV) in that domain. Children who were DV for two or more of the five main domains are classified as developmentally high risk (DHR) and this was the primary study outcome. Robust multivariable Poisson models were used to obtain individual and combined relative risks for gestational age and mode of birth with DHR, adjusted for maternal demographic, socio-economic, perinatal, and child characteristics. ResultsOverall, 9.6% of children were DHR. The adjusted relative risk (aRR) (95% confidence interval) of being DHR decreased with increasing gestational age (referent: 40 weeks)Íž 32-33 weeks 1.25 (1.08-1.44), 34­-36 weeks 1.26 (1.18-1.34), 37 weeks 1.17 (1.10-1.25), 38 weeks 1.06 (1.01-­1.10), 39 weeks 0.98 (0.94-1.02), 41+ weeks 0.99 (0.94-­1.03) and for planned birth (referent: vaginal birth following spontaneous labour), 1.07 (1.04­-1.11). The aRR for planned birth at 37 weeks was 1.26 (1.18-­1.34) and at 38 weeks 1.13 (1.08-­1.19). ConclusionEarly (
- Subjects :
- Pregnancy
education.field_of_study
Pediatrics
medicine.medical_specialty
Information Systems and Management
business.industry
Obstetrics
medicine.medical_treatment
Population
Gestational age
Health Informatics
medicine.disease
Child development
Cohort
Gestation
Medicine
Caesarean section
Early childhood
business
education
Information Systems
Demography
Subjects
Details
- ISSN :
- 23994908
- Volume :
- 1
- Database :
- OpenAIRE
- Journal :
- International Journal of Population Data Science
- Accession number :
- edsair.doi...........26eb0f5072f86b818dcc623bbac99abf