Early developmental outcomes predicted by gestational age from 35 to 41 weeks

Background: Recent studies have indicated that children born only a few weeks earlier than their due date experience more health and cognitive problems than previously realized. Aims: Our study investigated whether gestational age (GA) at birth (35-41 weeks) predicted developmental outcomes at 8, 12, 20, or 24 months of age. Study design: Archival records of developmental screening scores collected between 2006 and 2012 were analyzed using negative binomial and logistic regressions models. Subjects: Eight-month (N = 3319), 12-month (N = 2303), 20-month (N = 1461) and 24-month (N = 1222) old children were assessed in a county-wide developmental screening program. Outcome measures: Ages and Stage Questionnaires (ASQs) scores. Results: After controlling for demographic covariates, from 35 weeks of gestation on, each additional week of gestation (through 41) significantly reduced the overall risk for developmental delay at 8,12, 20 and 24-months of age. Gestational age also uniquely predicted specific risk for delay in the domains of communication, personal-social, fine-motor, and problem solving at various time-points during the first two years of life. Conclusions: With each additional week of gestation past 35 weeks there was a graded decrease in the overall risk of developmental delay as well as in specific domains such as communication across the first two years of life. This evidence for the "dose-response" effect of GA on later development suggests that close monitoring of developmental outcomes for children born before 40 weeks is warranted. (C) 2016 Elsevier Ireland Ltd. All rights reserved.