Gestational Age at Birth and Risk of Developmental Delay: The Upstate KIDS Study

Kimberly A. Hochstedler; Griffith Bell; Hyojun Park; Akhgar Ghassabian; Erin M. Bell; Rajeshwari Sundaram; Katherine L. Grantz; Edwina H. Yeung

doi:10.1055/s-0040-1702937

American Journal of Perinatology, Table of Contents

Am J Perinatol 2021; 38(10): 1088-1095
DOI: 10.1055/s-0040-1702937

Original Article

Gestational Age at Birth and Risk of Developmental Delay: The Upstate KIDS Study

Authors

Kimberly A. Hochstedler

¹Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
Griffith Bell

²Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
Hyojun Park

³Department of Sociology, Utah State University, Logan, Utah
Akhgar Ghassabian

⁴Departments of Pediatrics, Environmental Medicine, and Population Health, New York University School of Medicine, New York, New York
Erin M. Bell

⁵Departments of Environmental Health Sciences and Epidemiology and Biostatistics, University at Albany School of Public Health, Albany, New York
Rajeshwari Sundaram

⁶Biostatistics & Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
Katherine L. Grantz

²Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
Edwina H. Yeung

²Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland

Abstract

Objective The aim of this study is to model the association between gestational age at birth and early child development through 3 years of age.

Study Design Development of 5,868 children in Upstate KIDS (New York State; 2008–2014) was assessed at 7 time points using the Ages and Stages Questionnaire (ASQ). The ASQ was implemented using gestational age corrected dates of birth at 4, 8, 12, 18, 24, 30, and 36 months. Whether children were eligible for developmental services from the Early Intervention Program was determined through linkage. Gestational age was based on vital records. Statistical models adjusted for covariates including sociodemographic factors, maternal smoking, and plurality.

Results Compared with gestational age of 39 weeks, adjusted odds ratios (aOR) and 95% confidence intervals of failing the ASQ for children delivered at <32, 32–34, 35–36, 37, 38, and 40 weeks of gestational age were 5.32 (3.42–8.28), 2.43 (1.60–3.69), 1.38 (1.00–1.90), 1.37 (0.98–1.90), 1.29 (0.99–1.67), 0.73 (0.55–0.96), and 0.51 (0.32–0.82). Similar risks of being eligible for Early Intervention Program services were observed (aOR: 4.19, 2.10, 1.29, 1.20, 1.01, 1.00 [ref], 0.92, and 0.78 respectively for <32, 32–34, 37, 38, 39 [ref], 40, and 41 weeks).

Conclusion Gestational age was inversely associated with developmental delays for all gestational ages. Evidence from our study is potentially informative for low-risk deliveries at 39 weeks, but it is notable that deliveries at 40 weeks exhibited further lower risk.

Keywords

gestational age - developmental delay - preterm - early term

Full Text

References

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