Abstract Objective To study the effect of gestational age at birth on the neurobehavioral development of preschool children. Methods A total of 25 254 preschool children from Ma'anshan of Anhui Province, Taizhou of Zhejiang Province, and Yangzhou of Jiangsu Province were enrolled. The preschool children were divided into three groups based on their gestational ages at birth:preterm group (2 760 cases; 28-36+6 weeks), early term group (6 005 cases; 37-38+6 weeks), and full term group (16 489 cases; ≥ 39 weeks). The Ages and Stages Questionnaires-Third Edition (ASQ-3) was employed to evaluate the children's neurobehavioral development. Results The preterm group had significantly lower scores of the five domains of ASQ-3, communication, gross motor, fine motor, problem solving, and personal-social, than the full term group (P < 0.05), and significantly lower scores of communication, gross motor, fine motor, and problem solving than the early term group (P < 0.05). There were no significant differences in the scores of the five domains of ASQ-3 between the early term and full term groups (P > 0.05). The multiple linear regression analysis indicated a significant positive correlation between gestational age and the five domains of ASQ-3 after adjustment for confounding factors including sex, age, body mass index, and parental education level (P < 0.01). Conclusions Children born preterm have poorer neurobehavioral development than those born full term and early term, whereas children born full term and early term have similar neurobehavioral development. Gestational age at birth is an independent influencing factor for neurobehavioral development in preschool children.
LIU Ming-Xia,DAI Xiao-Tian,HUA Jing. Neurobehavioral development of 25 254 children with different gestational ages at birth in three cities of China[J]. CJCP, 2020, 22(9): 931-935.
LIU Ming-Xia,DAI Xiao-Tian,HUA Jing. Neurobehavioral development of 25 254 children with different gestational ages at birth in three cities of China[J]. CJCP, 2020, 22(9): 931-935.
ACOG Committee Opinion No 579:definition of term pregnancy[J]. Obstet Gynecol, 2013, 122(5):1139-1140.
[2]
Delnord M, Zeitlin J. Epidemiology of late preterm and early term births-an international perspective[J]. Semin Fetal Neonatal Med, 2019, 24(1):3-10.
[3]
Mally PV, Agathis NT, Bailey SM. Early term infants are at increased risk of requiring neonatal intensive care[J]. World J Pediatr, 2016, 12(1):76-81.
[4]
Kuzniewicz MW, Parker SJ, Schnake-Mahl A, et al. Hospital readmissions and emergency department visits in moderate preterm, late preterm, and early term infants[J]. Clin Perinatol, 2013, 40(4):753-775.
[5]
Laptook AR. Neurologic and metabolic issues in moderately preterm, late preterm, and early term infants[J]. Clin Perinatol, 2013, 40(4):723-738.
[6]
Hwang SS, Barfield WD, Smith RA, et al. Discharge timing, outpatient follow-up, and home care of late-preterm and early-term infants[J]. Pediatrics, 2013, 132(1):101-108.
[7]
Rabie NZ, Bird TM, Magann EF, et al. ADHD and developmental speech/language disorders in late preterm, early term and term infants[J]. J Perinatol, 2015, 35(8):660-664.
[8]
Rose O, Blanco E, Martinez SM, et al. Developmental scores at 1 year with increasing gestational age, 37-41 weeks[J]. Pediatrics, 2013, 131(5):e1475-e1481.
Bolk J, Farooqi A, Hafström M, et al. Developmental coordination disorder and its association with developmental comorbidities at 6.5 years in apparently healthy children born extremely preterm[J]. JAMA Pediatr, 2018, 172(8):765-774.
[12]
Kwok C, Mackay M, Agnew JA, et al. Does the Movement Assessment Battery for Children-2 at 3 years of age predict developmental coordination disorder at 4.5 years of age in children born very preterm?[J]. Res Dev Disabil, 2019, 84:36-42.
[13]
Spittle A, Orton J, Anderson PJ, et al. Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants[J]. Cochrane Database Syst Rev, 2015(11):CD005495.
[14]
Allotey J, Zamora J, Cheong-See F, et al. Cognitive, motor, behavioural and academic performances of children born preterm:a meta-analysis and systematic review involving 64061 children[J]. BJOG, 2018, 125(1):16-25.
[15]
Chatziioannidis I, Kyriakidou M, Exadaktylou S, et al. Neurological outcome at 6 and 12 months corrected age in hospitalised late preterm infants-a prospective study[J]. Eur J Paediatr Neurol, 2018, 22(4):602-609.
[16]
Sumanasena SP, Vipulaguna DV, Mendis MM, et al. Beyond survival:5-year neurodevelopmental follow-up of a cohort of preterm infants in Colombo, Sri Lanka[J]. Paediatr Int Child Health, 2018, 38(2):128-136.
[17]
Cheong JLY, Thompson DK, Olsen JE, et al. Late preterm births:new insights from neonatal neuroimaging and neurobehaviour[J]. Semin Fetal Neonatal Med, 2019, 24(1):60-65.
[18]
Huff K, Rose RS, Engle WA. Late preterm infants:morbidities, mortality, and management recommendations[J]. Pediatr Clin North Am, 2019, 66(2):387-402.
[19]
Sahni R, Polin RA. Physiologic underpinnings for clinical problems in moderately preterm and late preterm infants[J]. Clin Perinatol, 2013, 40(4):645-663.
Chollat C, Sentilhes L, Marret S. Fetal neuroprotection by magnesium sulfate:from translational research to clinical application[J]. Front Neurol, 2018, 9:247.
[22]
Gulati S, Sondhi V. Cerebral palsy:an overview[J]. Indian J Pediatr, 2018, 85(11):1006-1016.
[23]
Quigley MA, Poulsen G, Boyle E, et al. Early term and late preterm birth are associated with poorer school performance at age 5 years:a cohort study[J]. Arch Dis Child Fetal Neonatal Ed, 2012, 97(3):F167-F173.
[24]
Gurka MJ, LoCasale-Crouch J, Blackman JA. Long-term cognition, achievement, socioemotional, and behavioral development of healthy late-preterm infants[J]. Arch Pediatr Adolesc Med, 2010, 164(6):525-532.
[25]
Chan E, Leong P, Malouf R, et al. Long-term cognitive and school outcomes of late-preterm and early-term births:a systematic review[J]. Child Care Health Dev, 2016, 42(3):297-312.
[26]
Nielsen TM, Pedersen MV, Milidou I, et al. Long-term cognition and behavior in children born at early term gestation:a systematic review[J]. Acta Obstet Gynecol Scand, 2019, 98(10):1227-1234.
[27]
Panfoli I, Candiano G, Malova M, et al. Oxidative stress as a primary risk factor for brain damage in preterm newborns[J]. Front Pediatr, 2018, 6:369.
