summary: A new study reveals that moderately preterm birth (32 to 38 weeks) is associated with an increased risk of developmental disorders. Researchers analyzed more than 75 studies involving more than 8 million children and found that children born moderately prematurely were at increased risk of disabilities such as cerebral palsy, cognitive impairment, and language delay. .
Given that around 7% of infants in the UK are born moderately premature each year, the risk per child is small, but the population-level impact is significant. This study highlights the need for better understanding and support for these children, highlighting the role of health professionals and educators in early intervention and individualized support.
Important facts:
- Children born moderately preterm are at increased risk for language delays, lower educational attainment, and developmental disorders such as cerebral palsy.
- The study looked at data from more than 8 million children and found that the risk decreased with each additional week of gestation, but that the risk increased even after an “early” birth (37 to 38 weeks).
- The study calls for improved communication between schools, parents and health professionals, and more support for teachers in managing preterm children.
sauce: york university
Around 7 per cent of babies are born moderately premature in the UK each year, so while much of the increased risk is small, it could have a significant population-level impact, the National Institute for Health Research (NIHR)-funded study said. said the authors of the provided study. To tell.
For the study, researchers from the University of York, the University of Leeds and the University of Leicester examined data from more than 75 studies around the world, involving a total of more than 8 million children.
The study found an increased risk of most developmental disorders compared to children born at term. The risk decreased with each week of pregnancy, but even if the child was born “early” at 37 to 38 weeks, there was a slightly increased risk of some developmental disorders such as cerebral palsy, developmental delay, and cognitive impairment. There was still evidence that there was. .
One of the most common disorders was language delay, which affected 222 per 1000 children born between 32 and 36 weeks, compared with 47 per 1000 children born at term. Many children face low academic performance during their primary school years, with 300 per 1,000 children born moderately premature being affected compared to 160 per 1,000 children born at term. I am.
Although the risk of cerebral palsy is relatively low for all children, research suggests that the risk is 14 times higher for infants born at 32 to 33 weeks compared to children born at term. Masu.
The review also found that the challenges faced by children born between 32 and 38 weeks persist throughout childhood, with evidence of increased risk and prevalence of cognitive impairment and lower academic performance that persists into high school. did.
Lead author of the study, Dr Catherine Pettinger from York University's School of Health Sciences, said: During this period, many children do not experience developmental problems.
“The reasons behind our findings are not yet clear, but babies born just a few weeks early have different brain maturation than full-term babies, and babies born between 32 and 38 weeks of gestation have poorer neural connections. evolution may be impeded and potentially have an impact on developmental disorders.
“Many babies born moderately prematurely are delivered early for very good reasons, for example if the mother has a health condition such as pre-eclampsia. Understanding the long-term impact can influence obstetric decision-making in some cases.
“We also want to ensure that all health professionals, especially pediatricians, are well-informed about the potential consequences of preterm birth, provide evidence-based information to families, and avoid missing out on opportunities for early intervention.” That is also important.”
According to current guidelines from the National Institute for Health and Care Excellence (NICE), children born before 30 weeks of age should be supervised until they are two years old.
Researchers believe that all children born between 32 and 38 weeks of gestation will need regular health care, as many show no signs of developmental disorders and can put a significant strain on NHS services. We do not recommend that patients be diagnosed more than once.
But researchers are calling for stronger communication between schools, parents and health professionals, and better support for teachers.
Dr. Pettinger continued, “The data shows that the effects of just a few weeks of early birth are still felt even at elementary school age. It makes sense to let them know and receive training on how to support them.
“To investigate how the occurrence of developmental disorders is associated with gestational age and to consider a large population study to see if the patterns observed in this study are replicated. , further research is currently needed.
“Also, understanding which diseases are more likely to co-occur can help tailor interventions to children, so whether children commonly have multiple diseases or I would like to pay attention to this as well.”
About this neurodevelopmental research news
author: sherry hughes
sauce: york university
contact: Shelley Hughes – University of York
image: Image credited to Neuroscience News
Original research: Open access.
“Risk of developmental disorders in children born between 32 and 38 weeks of gestation: a meta-analysis.Written by Catherine Pettinger et al. Pediatrics
abstract
Risk of developmental disorders in children born between 32 and 38 weeks of gestation: a meta-analysis.
context
Very preterm birth (<32 weeks) is associated with an increased risk of developmental disorders. Emerging evidence suggests that children born between 32 and 38 weeks may also be at risk.
the purpose
We calculated the relative risk and prevalence of being diagnosed with a developmental disorder or screening positive for children born mid-term, late preterm, and early term. Judgment should be made by comparing with the newborn (39 to 40/41 weeks).
data source
Medline, Embase, Psychinfo, Cumulative Index of Nursing, and Allied Health Literature.
Research selection
One or more developmental disorders were reported and estimates were provided for children born between 32 and 38 weeks.
Data extraction
One reviewer extracted the data. 20% of the samples were checked on her second. Data were pooled using random effects meta-analysis.
result
Seventy-six studies were included. Compared with term infants, the risk of most developmental disorders was increased, particularly in the moderate preterm infant group, but also in the late preterm and early preterm groups. The relative risk for cerebral palsy between 32 and 33 weeks was 14.1 (95%).Confidence interval [CI]: 12.3-16.0), 34-36 weeks: 3.52 (95% CI: 3.16-3.92), 37-38 weeks: 1.44 (95% CI: 1.32-1.58).
Limitations
Studies evaluated children of different ages using different criteria. The majority were from economically developed countries. All published in English. The data were sparse. Subgroup comparisons were sometimes based on a single study.
conclusion
Children born moderately preterm have a higher risk of being diagnosed with a developmental disorder or having a positive screening test for developmental disorders than children born at term. This association was also shown in late preterm and early preterm groups, but the effect size was smaller.
