Early Term Children Research Articles

Associations of preterm and early-term birth with suspected developmental coordination disorder: a national retrospective cohort study in children aged 3–10 years

BackgroundThis study analyzed the motor development and suspected developmental coordination disorder of very and moderately preterm (< 34+0 gestational age), late preterm (34+0–36+6 gestational week), and early-term (37+0–38+6 gestational week) children compared to their full-term peers with a national population-based sample in China.MethodsA total of 1673 children (799 girls, 874 boys) aged 3–10 years old were individually assessed with the Movement Assessment Battery for Children-second edition (MABC-2). The association between gestational age and motor performance of children was analyzed using a multilevel regression model.ResultsThe global motor performance [β = – 5.111, 95% confidence interval (CI) = – 9.200 to – 1.022; P = 0.015] and balance (β = – 5.182, 95% CI = – 5.055 to – 1.158; P = 0.003) for very and moderately preterm children aged 3–6 years old were significantly lower than their full-term peers when adjusting for confounders. Late preterm and early-term children showed no difference. Moreover, very and moderately preterm children aged 3–6 years had a higher risk of suspected developmental coordination disorder (DCD) (≤ 5 percentile of MABC-2 score) when adjusting for potential confounders [odds ratio (OR) = 2.931, 95% CI = 1.067–8.054; P = 0.038]. Late preterm and early-term children showed no difference in motor performance from their full-term peers (each P > 0.05).ConclusionsOur findings have important implications for understanding motor impairment in children born at different gestational ages. Very and moderately preterm preschoolers have an increased risk of DCD, and long-term follow-up should be provided for early detection and intervention.

Gestational age on trajectories of social competence difficulties into adolescence

ObjectivesTo examine if gestational age groups predict the development of social competence difficulties (SCDs) from childhood into mid-adolescence and to assess the mediation by maternal psychological distress during infancy on...

Long-term Cognition and Behavior in Children Born at Early-Term Gestation: A Systematic Review

(Acta Obstet Gynecol Scand. 2019;98:1227–1234) Infants that are born between 37 and 38 weeks gestation carry higher risk of neonatal morbidity in comparison to infants born at or after 39 weeks gestation, and the American College of Obstetricians and Gynecologists has designated infants born at 37+0 weeks through 38+6 weeks as “early-term.” This is a change from the previously held belief that all “term” infants (infants born after 37+0 wk gestation) are similar in development. Recent studies have suggested that late-preterm children (born from 34+0 and 36+6 wk) are more likely to have academic challenges and behavioral problems, although the evidence provided is not definitive. Nielsen and collegues conducted this systematic review to thoroughly examine the literature on the differences between early-term children compared with full-term children in long-term cognitive, educational, and behavioral outcomes.

Out-of-home care placements of children and adolescents born preterm: A register-based cohort study.

Preterm birth predisposes to child protection action in the form out-of-home care. The impact of the degree of preterm birth on the likelihood for OHC placement(s) and their timing is unknown. This population-based register-linkage study assessed the likelihood of OHC placement in different gestational age groups using multivariable Cox regression models. All 193033 traceable singleton (8324 preterm, 4.3%) liveborn in Finland (January 1987-September 1990), as the first index child of each mother within the cohort period, were followed up until their 18th birthday. A total of 6562 children (3.4%) experienced OHC. In comparison with full-term children (39-41weeks), those born at 23-33 completed weeks were predisposed to OHC (hazard ratio [HR] 2.11, 95% confidence interval [CI] 1.74, 2.56). For those born late preterm (34-36weeks) and early term (37-38weeks), the HR were 1.54 (95% CI 1.37, 1.73) and 1.19 (95% CI 1.12, 1.26), respectively. Adjustment for parental and child characteristics attenuated the HRs: 23-33weeks: 1.31 (95% CI 1.07, 1.59), 34-36weeks: 1.17 (95% CI 1.04, 1.31), and 37-38weeks: 1.08 (95% CI 1.02, 1.16). However, the adjusted HRs for first OHC entries at 0-5years of age were higher: 23-33weeks 2.29 (95% CI 1.72, 3.05), 34-36weeks 1.76 (95% CI 1.46, 2.13), and 37-38weeks 1.40 (95% CI 1.25, 1.56). Among those born preterm or early term, in comparison with their term born peers, no excess risk for OHC was seen after 5years. A dose-response relationship exists between the level of preterm birth and OHC placement risk. OHC placements are more common among early and late preterm, and early term children, compared with those born full term, and occur at younger age. Perinatal and postnatal adverse circumstances appear to explain the phenomenon only partly.

Differentiating the cognitive development of early-term births in infants and toddlers: a cross-sectional study in China

ObjectivesThis study aimed to explore the cognitive development of low-risk children during early childhood for early-term births at 37 and 38 weeks of gestation compared with full term births at...

Lower respiratory tract disorder hospitalizations among children born via elective early-term delivery

Objective: We evaluated the hypothesis that elective early-term delivery increases the risk of childhood lower respiratory tract disorder hospitalization.Methods: Children born via early-term elective inductions were compared to full- or late-term elective inductions in a retrospective cohort study using Washington State birth certificate and hospital discharge data. Outcomes were the odds of lower respiratory disorder hospitalization before age five and cause specific odds ratios for asthma, bronchiolitis, bronchitis, and pneumonia. In addition, a subgroup analysis excluding infants with perinatal complications was conducted.Results: Electively induced early-term children were at significantly increased risk of hospitalization before age five for lower respiratory disorders compared to similar full- or late-term children (adjusted OR: 1.31, 95% CI: 1.11–1.55). Bronchiolitis was the only cause-specific outcome with a statistically significant increase in odds of hospitalization, though comparable increases were found for the less common diagnoses of asthma (adjusted OR: 1.39, 95% CI: 0.93–2.08) and pneumonia (adjusted OR: 1.27, 95% CI: 0.99–1.64). Excluding infants with perinatal complications did not alter the results.Conclusions: There was an association between electively induced early-term delivery and hospitalization for lower respiratory tract disorders before age five. This reinforces policies discouraging elective early-term delivery.

Anthropometry, glucose homeostasis and lipid profile in prepubertal children born early, full, or late term

To examine differences in growth and metabolism in prepubertal children born early term, full term, and late term. We retrospectively studied 294 prepubertal children aged 7.3 years (range 3.0–12.1 years). Children were separated into those born early term (37 0/7–38 6/7 weeks of gestation; n = 68), full term (39 0/7–40 6/7 weeks; n = 179), and late term (41 0/7–41 6/7 weeks; n = 47). Clinical assessments included anthropometry, DXA-derived body composition, fasting lipids, and glucose homeostasis. Statistical models accounted for important confounding factors, such as gender, age, birth weight SDS, birth order, and parental variables. When birth weight was adjusted for sex and gestational age (birth weight SDS), late terms were heavier than both early (p = 0.034) and full (p = 0.020) terms. Early term children were shorter than both full (p = 0.010) and late (p = 0.049) term children, but differences in height disappeared following correction for parents' heights. There were no differences in glucose homeostasis, BMI SDS, adiposity, or fat distribution between groups. Lipid profiles were also similar. When important confounding factors were accounted for, there were no meaningful differences in anthropometry, glucose homeostasis, and lipid profile among children born early term, full term, or late term.

School performance at age 7 years in late preterm and early term birth: a cohort study

ObjectiveTo investigate the effect of gestational age, particularly late preterm birth (34–36 weeks gestation) and early term birth (37–38 weeks gestation) on school performance at age 7 years.DesignPopulation-based prospective UK...

Late Preterm Birth, Maternal Depression, and Risk of Preschool Psychiatric Disorders

ObjectivePreterm children are at greater risk for psychiatric disorders, including anxiety disorders and attention-deficit/hyperactivity disorder (ADHD), than their term-born peers. Prior research has focused primarily on children born at early gestational ages. Less is known about the rate of psychiatric disorders among late preterm or early term children. In addition, whether a history of maternal depression also associated with prematurity has an impact on the risk for psychiatric disorders remains underexplored. MethodPreschoolers between ages 3 and 6 years (N = 306) were recruited for a study examining preschool depression that included healthy and disruptive preschoolers. Preschoolers were placed in the following groups: late preterm (34–36 weeks, n = 39), early term (37–39 weeks, n = 78), and full term (40–41 weeks, n = 154). DSM-IV psychiatric disorders were assessed via the Preschool Age Psychiatric Assessment. Maternal history of psychiatric disorders was assessed using the Family Interview for Genetic Studies. ResultsLate preterm children had higher rates of any Axis I psychiatric diagnosis (odds ratio = 3.18, 95% confidence interval = 1.09–4.76) and of any anxiety disorder (odds ratio = 3.74, 95% confidence interval = 1.59–8.78) than full term children after adjusting for gender, ethnicity, family income, and IQ. There were no differences in rates of psychiatric diagnoses between early term and full term children. A history of maternal depression mediated the relationship between late preterm birth and anxiety disorders in preschoolers. ConclusionsLate preterm children were at increased risk for anxiety disorders at preschool age. A history of maternal depression mediated this association. Findings confirm the extension of the risk of psychiatric disorders associated with prematurity to the late preterm group, and suggest that maternal depression may play a key role in this risk trajectory.

Children who are born just a few weeks premature are more likely to have poorer school performance than those born at full term

ObjectiveWhile it is well known that extreme prematurity is associated with poorer health and cognitive development, less is known about the effect of being born just a few weeks premature....