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Planned Birth Before 39 Weeks and Child Development: A Population-Based Study
Abstract
OBJECTIVE: To investigate the association of gestational age and mode of birth with early child development. METHODS: Population-based record linkage cohort study was conducted among 153 730 live-born infants of ≥32 weeks’ gestation with developmental assessments at school age, in New South Wales, Australia, 2002 to 2007. Children were assessed in 5 domains: physical health and well-being, language and cognition, social competence, emotional maturity, and general knowledge and communication. Children scoring in the bottom 10% of national domains were considered developmentally vulnerable, and children developmentally vulnerable for ≥2 domains were classified as developmentally high risk (DHR), the primary outcome. Robust multivariable Poisson models were used to obtain individual and combined adjusted relative risks (aRRs) of gestational age and mode of birth for DHR children. RESULTS: Overall, 9.6% of children were DHR. The aRR (95% confidence interval) of being DHR increased with decreasing gestational age (referent: 40 weeks); 32 to 33 weeks 1.25 (1.08–1.44), 34 to 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 labor induction or prelabor cesarean delivery (planned birth; referent: vaginal birth after spontaneous labor), 1.07 (1.04–1.11). The combined aRR for planned birth was 1.26 (1.18–1.34) at 37 weeks and 1.13 (1.08–1.19) at 38 weeks. CONCLUSIONS: Early (at <39 weeks) planned birth is associated with an elevated risk of poor child development at school age. The timing of planned birth is modifiable, and strategies to inform more judicious decision-making are needed to ensure optimal child health and development.
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“Our results are consistent with results from the only previous study that we are aware of by Bentley et al.31, which found cesarean-born children had a 14% higher risk of being identified as being developmentally high risk at school starting age.”
From The relation between cesarean birth and child cognitive development (2017) · cites this paper as [31]
In the citing paper
“Our results are consistent with results from the only previous study that we are aware of by Bentley et al.31, which found cesarean-born children had a 14% higher risk of being identified as being developmentally high risk at school starting age.”
From The relation between cesarean birth and child cognitive development (2017) · cites this paper as [31]
In the citing paper
“To the best of our knowledge, only Bentley et al.31 has examined the relation between cesarean birth and cognitive outcomes.”
From The relation between cesarean birth and child cognitive development (2017) · cites this paper as [31]
In the citing paper
“Bentley et al.31 used perinatal records linked to school starting-age measures of cognition and could not examine longer-term outcomes or quantify mediating effects.”
From The relation between cesarean birth and child cognitive development (2017) · cites this paper as [31]
In the citing paper
“Using Australian hospital records linked to teacher-based assessments in the first year of school, they found a significant negative association across several developmental domains.”
From The relation between cesarean birth and child cognitive development (2017) · cites this paper as [31]
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Metadata
- Authors
- Bentley, J. P., Roberts, C. L., Bowen, J. R., Martin, A. J., Morris, J. M., & Nassar, N.
- Affiliations
- The University of Sydney (AU)
- Northern Sydney Local Health District (AU)
- Royal North Shore Hospital (AU)
- UNSW Sydney (AU)
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2016-12-01
- Volume
- 138
- Issue
- 6
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2551385132
- Cited by
- 127
- References
- 57
- Citations by year
- 2026: 4 · 2025: 8 · 2024: 18 · 2023: 13 · 2022: 11 · 2021: 22 · 2020: 16 · 2019: 14 · 2018: 9 · 2017: 7 · 2016: 2
- FWCI
- 12.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Australian Government
- NSW Ministry of Health
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Infant Development and Preterm Care
- Health Sciences › Medicine › Obstetrics and Gynecology › Maternal and Perinatal Health Interventions
- Health Sciences › Medicine › Obstetrics and Gynecology › Preterm Birth and Chorioamnionitis
- Keywords
- preterm birth, gestational age, mode of delivery, labor induction, child development, developmental vulnerability, elementary school students, language and cognition, social competence, emotional maturity
- MeSH terms
- Developmental Disabilities, Child, Preschool, Cross-Sectional Studies, Female, Gestational Age, Humans, Infant, Newborn, Infant, Premature, Labor, Induced, Male, New South Wales, Patient Care Planning, Pregnancy, Pregnancy Outcome, Prenatal Care, Prognosis, Retrospective Studies, Cohort Studies, Multivariate Analysis, Logistic Models, Risk Assessment, Premature Birth
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