Am J Perinatol
DOI: 10.1055/s-0040-1702937
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

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

Kimberly A. Hochstedler
1  Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
,
Griffith Bell
2  Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
,
Hyojun Park
3  Department of Sociology, Utah State University, Logan, Utah
,
Akhgar Ghassabian
4  Departments of Pediatrics, Environmental Medicine, and Population Health, New York University School of Medicine, New York, New York
,
Erin M. Bell
5  Departments of Environmental Health Sciences and Epidemiology and Biostatistics, University at Albany School of Public Health, Albany, New York
,
Rajeshwari Sundaram
6  Biostatistics & Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
,
Katherine L. Grantz
2  Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
,
Edwina H. Yeung
2  Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
› Author Affiliations
Funding This study is supported by the Intramural Research Program of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD; contracts #HHSN275201200005C and #HHSN267200700019C).
Further Information

Publication History

13 August 2019

09 January 2020

Publication Date:
06 March 2020 (online)

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.

Note

NICHD approved the manuscript for publication but played no role in the study design, data collection, data analysis or interpretation, writing of the manuscript, or the decision to submit the article for publication.