Gestational age at birth and child special educational needs: a UK representative birth cohort study

ObjectiveTo examine the association between gestational age at birth across the entire gestational age spectrum and special educational needs (SENs) in UK children at 11 years of age.MethodsThe Millennium Cohort Study is a nationally representative longitudinal sample of children born in the UK during 2000–2002. Information about the child’s birth, health and sociodemographic factors was collected when children were 9 months old. Information about presence and reasons for SEN was collected from parents at age 11. Adjusted relative risks (aRRs) were estimated using modified Poisson regression, accounting for confounders.ResultsThe sample included 12 081 children with data at both time points. The overall prevalence of SEN was 11.2%, and it was inversely associated with gestational age. Among children born <32 weeks of gestation, the prevalence of SEN was 27.4%, three times higher than among those born at 40 weeks (aRR=2.89; 95% CI 2.02 to 4.13). Children born early term (37–38 weeks) were also at increased risk for SEN (aRR=1.33; 95% CI 1.11 to 1.59); this was the same when the analysis was restricted to births after labour with spontaneous onset. Birth before full term was more strongly associated with having a formal statement of SEN or SEN for multiple reasons.ConclusionChildren born at earlier gestational ages are more likely to experience SEN, have more complex SEN and require support in multiple facets of learning. This association was observed even among children born early-term and when labour began spontaneously.

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Correction: Gestational age at birth and child special educational needs: a UK representative birth cohort study

Archives of Disease in Childhood ◽

10.1136/archdischild-2020-320213corr1 ◽

2021 ◽

Vol 106 (11) ◽

pp. e44-e44

Keyword(s):

Cohort Study ◽

Birth Cohort ◽

Gestational Age ◽

Educational Needs ◽

Birth Cohort Study ◽

Special Educational Needs ◽

Gestational Age At Birth ◽

Age At Birth

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Preterm birth and risk of chronic kidney disease from childhood into mid-adulthood: national cohort study

BMJ ◽

10.1136/bmj.l1346 ◽

2019 ◽

pp. l1346 ◽

Cited By ~ 48

Author(s):

Casey Crump ◽

Jan Sundquist ◽

Marilyn A Winkleby ◽

Kristina Sundquist

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Environmental Factors ◽

Gestational Age ◽

Early Term ◽

Extremely Preterm ◽

National Cohort ◽

Gestational Age At Birth ◽

Age At Birth

Abstract Objective To investigate the relation between preterm birth (gestational age <37 weeks) and risk of CKD from childhood into mid-adulthood. Design National cohort study. Setting Sweden. Participants 4 186 615 singleton live births in Sweden during 1973-2014. Exposures Gestational age at birth, identified from nationwide birth records in the Swedish birth registry. Main outcome measures CKD, identified from nationwide inpatient and outpatient diagnoses through 2015 (maximum age 43 years). Cox regression was used to examine gestational age at birth and risk of CKD while adjusting for potential confounders, and co-sibling analyses assessed the influence of unmeasured shared familial (genetic or environmental) factors. Results 4305 (0.1%) participants had a diagnosis of CKD during 87.0 million person years of follow-up. Preterm birth and extremely preterm birth (<28 weeks) were associated with nearly twofold and threefold risks of CKD, respectively, from birth into mid-adulthood (adjusted hazard ratio 1.94, 95% confidence interval 1.74 to 2.16; P<0.001; 3.01, 1.67 to 5.45; P<0.001). An increased risk was observed even among those born at early term (37-38 weeks) (1.30, 1.20 to 1.40; P<0.001). The association between preterm birth and CKD was strongest at ages 0-9 years (5.09, 4.11 to 6.31; P<0.001), then weakened but remained increased at ages 10-19 years (1.97, 1.57 to 2.49; P<0.001) and 20-43 years (1.34, 1.15 to 1.57; P<0.001). These associations affected both males and females and did not seem to be related to shared genetic or environmental factors in families. Conclusions Preterm and early term birth are strong risk factors for the development of CKD from childhood into mid-adulthood. People born prematurely need long term follow-up for monitoring and preventive actions to preserve renal function across the life course.

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Risk of hypertension into adulthood in persons born prematurely: a national cohort study

European Heart Journal ◽

10.1093/eurheartj/ehz904 ◽

2019 ◽

Vol 41 (16) ◽

pp. 1542-1550 ◽

Cited By ~ 7

Author(s):

Casey Crump ◽

Jan Sundquist ◽

Kristina Sundquist

Keyword(s):

Cohort Study ◽

Preterm Birth ◽

Environmental Factors ◽

Gestational Age ◽

Large Population ◽

Increased Risk ◽

Extremely Preterm ◽

National Cohort ◽

Gestational Age At Birth ◽

Age At Birth

Abstract Aims Preterm birth has been associated with elevated blood pressure early in life; however, hypertension risks from childhood into adulthood remain unclear. We conducted a large population-based study to examine gestational age at birth in relation to hypertension risks from childhood into adulthood. Methods and results A national cohort study was conducted of all 4 193 069 singleton live births in Sweden during 1973–2014, who were followed up for hypertension identified from nationwide inpatient and outpatient (specialty and primary care) diagnoses from any health care encounters through 2015 (maximum age 43 years; median 22.5). Cox regression was used to examine gestational age at birth in relation to hypertension risk while adjusting for other perinatal and maternal factors, and co-sibling analyses assessed the potential influence of unmeasured shared familial (genetic and/or environmental) factors. In 86.8 million person-years of follow-up, 62 424 (1.5%) persons were identified with hypertension (median age 29.8 years at diagnosis). Adjusted hazard ratios for new-onset hypertension at ages 18–29 years associated with preterm (<37 weeks) and extremely preterm (22–27 weeks) birth were 1.28 [95% confidence interval (CI), 1.21–1.36] and 2.45 (1.82–3.31), respectively, and at ages 30–43 years were 1.25 (1.18–1.31) and 1.68 (1.12–2.53), respectively, compared with full-term birth (39–41 weeks). These associations affected males and females similarly and appeared substantially related to shared genetic or environmental factors in families. Conclusions In this large national cohort, preterm birth was associated with increased risk of hypertension into early adulthood. Persons born prematurely may need early preventive evaluation and long-term monitoring for the development of hypertension.

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Gestational age at birth and behavioral problems from four to 11 years of age: birth cohort study

BMC Pediatrics ◽

10.1186/s12887-017-0936-3 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 5

Author(s):

Iná S. Santos ◽

Fernando C. Barros ◽

Tiago Munhoz ◽

Alicia Matijasevich

Keyword(s):

Cohort Study ◽

Birth Cohort ◽

Gestational Age ◽

Behavioral Problems ◽

Birth Cohort Study ◽

Gestational Age At Birth ◽

Age At Birth

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Faculty Opinions recommendation of Effects of gestational age at birth on health outcomes at 3 and 5 years of age: population based cohort study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.14264188.15777343 ◽

2012 ◽

Author(s):

Mark Sullivan

Keyword(s):

Cohort Study ◽

Health Outcomes ◽

Gestational Age ◽

Population Based ◽

Gestational Age At Birth ◽

Age At Birth

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512: Are appropriately sized fetuses who “fall off the curve” at increased risk for small-for-gestational age at birth?

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2017.11.038 ◽

2018 ◽

Vol 218 (1) ◽

pp. S306-S307

Author(s):

Nathan R. Blue ◽

Mariam Savabi ◽

Meghan E. Beddow ◽

Vivek R. Katukuri ◽

Cody M. Fritts ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Increased Risk ◽

Gestational Age At Birth ◽

Age At Birth

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Effects of gestational age at birth on perinatal structural brain development in healthy term-born babies

10.1101/2021.05.02.442327 ◽

2021 ◽

Author(s):

Oliver Gale-Grant ◽

Sunniva Fenn-Moltu ◽

Lucas Franca ◽

Ralica Dimitrova ◽

Daan Christiaens ◽

...

Keyword(s):

Linear Regression ◽

Gestational Age ◽

Neurodevelopmental Outcome ◽

Magnetic Resonance Images ◽

Linear Regression Models ◽

Early Term ◽

Gestational Age At Birth ◽

The Impact ◽

Age At Birth ◽

Structural Brain

Multiple studies have demonstrated less favourable childhood outcomes in infants born in early term (37-38 weeks gestation) compared to those born at full term (40-41 weeks gestation). While this could be due to lower birthweight and greater perinatal morbidity, gestational age at birth may also have a direct effect on the brain and subsequent neurodevelopment in term-born babies. Here we characterise structural brain correlates of gestational age at birth in healthy term-born neonates and their relationship to later neurodevelopmental outcome. We used T2 and diffusion weighted Magnetic Resonance Images acquired in the neonatal period from a cohort (n=454) of healthy babies born at term age (>37 weeks gestation) and scanned between 1 and 41 days after birth. Images were analysed using tensor based morphometry (TBM) and tract based spatial statistics (TBSS). Neurodevelopment was subsequently assessed at age 18 months using the Bayley-III Scales of Infant and Toddler Development (n=281), and the effects of gestational age at birth and related neuroimaging findings on outcome were analysed with linear regression. Infants born earlier had areas of higher relative ventricular volume, and lower relative brain volume in the basal ganglia, cerebellum and brainstem. Earlier birth was also associated with lower fractional anisotropy, higher mean, axial and radial diffusivity in major white matter tracts. Gestational age at birth was positively associated with all Bayley-III subscales at age 18 months. Linear regression models predicting outcome from gestational age at birth were significantly improved by adding neuroimaging features associated with gestational age at birth. This work adds to the growing body of evidence of the impact of early term birth and highlights the importance of considering the effect of gestational age at birth in future neuroimaging studies including term-born babies.

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High-Dose Erythropoietin in Extremely Low Gestational Age Neonates Does Not Alter Risk of Retinopathy of Prematurity

Neonatology ◽

10.1159/000511262 ◽

2020 ◽

pp. 1-8

Author(s):

Dennis E. Mayock ◽

Zimeng Xie ◽

Bryan A. Comstock ◽

Patrick J. Heagerty ◽

Sandra E. Juul ◽

...

Keyword(s):

Birth Weight ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

High Frequency ◽

High Dose ◽

Heart Murmur ◽

Treatment Groups ◽

Increased Risk ◽

Gestational Age At Birth ◽

Age At Birth

Introduction: The Preterm Erythropoietin (Epo) Neuroprotection (PENUT) Trial sought to determine the safety and efficacy of early high-dose Epo as a potential neuroprotective treatment. We hypothesized that Epo would not increase the incidence or severity of retinopathy of prematurity (ROP). Methods: A total of 941 infants born between 24–0/7 and 27–6/7 weeks’ gestation were randomized to 1,000 U/kg Epo or placebo intravenously for 6 doses, followed by subcutaneous or sham injections of 400 U/kg Epo 3 times a week through 32 weeks post-menstrual age. In this secondary analysis of PENUT trial data, survivors were evaluated for ROP. A modified intention-to-treat approach was used to compare treatment groups. In addition, risk factors for ROP were evaluated using regression methods that account for multiples and allow for adjustment for treatment and gestational age at birth. Results: Of 845 subjects who underwent ROP examination, 503 were diagnosed with ROP with similar incidence and severity between treatment groups. Gestational age at birth, birth weight, prenatal magnesium sulfate, maternal antibiotic exposure, and presence of heart murmur at 2 weeks predicted the development of any ROP, while being on high-frequency oscillator or high-frequency jet ventilation (HFOV/HFJV) at 2 weeks predicted severe ROP. Conclusion: Early high-dose Epo followed by maintenance dosing through 32 weeks does not increase the risk of any or severe ROP in extremely low gestational age neonates. Gestational age, birth weight, maternal treatment with magnesium sulfate, antibiotic use during pregnancy, and presence of a heart murmur at 2 weeks were associated with increased risk of any ROP. Treatment with HFOV/HFJV was associated with an increased risk of severe ROP.

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