Early Developmental Outcomes Predicted by Gestational Age From 35 to 41 Weeks

One third of children are born preterm. Studies have found increases in medical complications and cognitive delay among children born even a few weeks before their due date. Specifically, studies reveal adverse clinical and developmental problems among children born between 34 and 36weeks' gestation (late preterm[LPT]) and even those born between 37 and 38 weeks' gestation (early term [ET]). The evidence for medical complications including respiratory complications, metabolic issues, and hyperbilirubinemia is broad, with fewer studies delving into the specific impact on long-term developmental issues by week of gestation. The current study focused on examining the effect of 1 week of gestation on a range of developmental measures. Using the Ages and Stages Questionnaire (ASQ), a reliable developmental screening tool, the study aimed at finding out whether births occurring at LPT or ET affected childhood development and examined the impact of 1 week of gestation between 35 and 41 weeks' gestation. This was a retrospective cohort study, and the data were extracted from development assessments made by Michigan-based Family Futures' Connections program that conducts countrywide developmental screening programs. Four sets of samples were collected from scores recorded between 2006 and 2012. The criterion for eligibility was completion of at least 1 ASQ at the age of 8 months, 12 months, 20 months, and 2 years. The total number of subjects in the 8-month sample group was 3319. There were 2303 in the 12-month group, 1461 in the 20-month group, and 1222 in the last group. Analysis was done using negative binomial and logistic regressions models. The associations between gestational age (GA) and the risk of developmental delay both overall and in specific developmental domains were examined. Overall, the study found that, after controlling for a set of demographic covariates, with each increasing week of gestation, the risk of overall development delay declined. During the first 2 years of growth, development delays in communication, problem solving, personal-social, gross-motor, and fine-motor domains were observed with earlier GAs at birth. For example, the odds ratio for 1-week gestation and developmental delay in communication was 1.27 (95% confidence interval, 1.08-1.54), meaning that with each week earlier than the term period there was a 27% higher chance of developmental delay. The conclusions drawn were that the last 6 weeks of gestation is a crucial period for neurological development. It can be concluded that the dose response of GA that is reflected in the formof increased risk of developmental delays calls for the need of extra attention to those children born before completion of full gestation period.