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Effects of gestational age at birth on health outcomes at 3 and 5 years of age: population based cohort study
Open accessAbstract
OBJECTIVE: To investigate the burden of later disease associated with moderate/late preterm (32-36 weeks) and early term (37-38 weeks) birth. DESIGN: Secondary analysis of data from the Millennium Cohort Study (MCS). SETTING: Longitudinal study of infants born in the United Kingdom between 2000 and 2002. PARTICIPANTS: 18,818 infants participated in the MCS. Effects of gestational age at birth on health outcomes at 3 (n = 14,273) and 5 years (n = 14,056) of age were analysed. MAIN OUTCOME MEASURES: Growth, hospital admissions, longstanding illness/disability, wheezing/asthma, use of prescribed drugs, and parental rating of their children's health. RESULTS: Measures of general health, hospital admissions, and longstanding illness showed a gradient of increasing risk of poorer outcome with decreasing gestation, suggesting a "dose-response" effect of prematurity. The greatest contribution to disease burden at 3 and 5 years was in children born late/moderate preterm or early term. Population attributable fractions for having at least three hospital admissions between 9 months and 5 years were 5.7% (95% confidence interval 2.0% to 10.0%) for birth at 32-36 weeks and 7.2% (1.4% to 13.6%) for birth at 37-38 weeks, compared with 3.8% (1.3% to 6.5%) for children born very preterm (<32 weeks). Similarly, 2.7% (1.1% to 4.3%), 5.4% (2.4% to 8.6%), and 5.4% (0.7% to 10.5%) of limiting longstanding illness at 5 years were attributed to very preterm birth, moderate/late preterm birth, and early term birth. CONCLUSIONS: These results suggest that health outcomes of moderate/late preterm and early term babies are worse than those of full term babies. Additional research should quantify how much of the effect is due to maternal/fetal complications rather than prematurity itself. Irrespective of the reason for preterm birth, large numbers of these babies present a greater burden on public health services than very preterm babies.
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Metadata
- Authors
- Boyle, E. M., Poulsen, G., Field, D. J., Kurinczuk, J. J., Wolke, D., Alfirevic, Z., & Quigley, M. A.
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 2012-03-01
- Volume
- 344
- Issue
- mar01 2
- Pages
- e896-e896
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- OpenAlex
- W2148733119
- Cited by
- 412
- References
- 0
- FWCI
- 31.19
- Type
- journal article
- Language
- en
- Open access
- hybrid
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- Boyle, E. M., Poulsen, G., Field, D. J., Kurinczuk, J. J., Wolke, D., Alfirevic, Z., & Quigley, M. A. (2012). Effects of gestational age at birth on health outcomes at 3 and 5 years of age: population based cohort study. BMJ. https://doi.org/10.1136/bmj.e896
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