Abstract
Early-term birth (37+0 to 38+6 gestational weeks) may have a negative impact on infants’ neurodevelopment compared to delivery at 39 weeks or beyond. The purpose of this study was to evaluate the gross motor development of early-term infants using the Alberta Infant Motor Scale (AIMS). A total of 1087 healthy infants (559 early-term and 528 full-term infants born at 39+0 to 41+6 weeks of gestation) were studied. Mean AIMS scores were compared between the two groups at monthly intervals. The impact of gestational age on total AIMS scores was assessed by linear regression, after adjustment for chronological age, sex and SGA. Mean total AIMS scores, albeit within normal range, were significantly lower in early-term than full-term infants at the 2nd, 6th, 7th, 8th and 12th month of age; differences between groups were within three points. In multivariate regression analysis, a longer gestation by one week had a positive impact on total AIMS score during the first year of life (β = 0.90; 95% CI 0.45, 1.35). In conclusion, early-term infants exhibit worse gross motor performance during the first year of life in comparison with their full-term peers; however, the differences between the two groups are small.
Highlights
In November 2013, the American College of Obstetricians and Gynecologists and the Society for Maternal and Fetal Medicine recommended that the label “term” birth, classically defined to describe all deliveries occurring at or beyond 37+0 weeks of gestation, should be discouraged and replaced by the new gestational age designations; early-term (37+0 to 38+6 weeks of gestation), full-term (39+0 to 40+6 weeks of gestation), late-term (41+0 to 41+6 weeks of gestation) and post-term (42+0 weeks of gestation and beyond) due to lack of uniformity in neonatal outcomes [1]
Mean ± SD values of total Alberta Infant Motor Scale (AIMS) raw scores were significantly lower in early-term than full-term infants at 2, 6, 7, 8 and 12 months of age (Table 1)
It has been reported that early-term birth is an independent risk factor for cerebral palsy [24], whereas Schonhaut et al showed that early-term infants, assessed by the Ages and Stages Questionnaire (ASQ) at 8–18 months of age, had a higher risk in developing gross motor function delays compared to their mature counterparts [25]
Summary
In November 2013, the American College of Obstetricians and Gynecologists and the Society for Maternal and Fetal Medicine recommended that the label “term” birth, classically defined to describe all deliveries occurring at or beyond 37+0 weeks of gestation, should be discouraged and replaced by the new gestational age designations; early-term (37+0 to 38+6 weeks of gestation), full-term (39+0 to 40+6 weeks of gestation), late-term (41+0 to 41+6 weeks of gestation) and post-term (42+0 weeks of gestation and beyond) due to lack of uniformity in neonatal outcomes [1]. Several studies have shown that early-term birth is associated with increased neonatal and infant morbidity and mortality compared with deliveries at 39 weeks of gestation or more [2,3,4]. In addition to perinatal outcomes, infants born in the early-term period are considered to be at risk for adverse long-term outcomes in several aspects, especially in neurodevelopment [3,5]. It has been reported that compared with children born full-term, early-term birth has a negative impact on cognitive [6,7] and motor development [8,9], behavior and emotional status [8,10,11], communication skills and social outcomes [8,12], school performance and academic achievements [8,13,14,15]. Given that early-term birth rates account for a significant percentage, varying from 15% to 31% among singleton live births across countries [17], further studies on outcomes of these infants are of potential clinical importance
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