Higher risk of developmental disorders in moderately premature babies

Developmental disorder risk in children born at 32-38 weeks.

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Babies born between 32 and 38 weeks have a higher chance of developmental disorders like language delay, cognitive issues, ADHD, and Cerebral palsy compared to full-term births, according to a recent critical study.

The NIHR-funded study by University of York, Leeds, and Leicester researchers analyzed data from over 75 global studies with eight million children. It found that babies born moderately preterm (between 32-38 weeks) in the UK, about seven percent annually, face increased risks of developmental disorders. Though individual risks are small, they could have significant population-level consequences. The study noted higher risks for conditions like cerebral palsy and cognitive impairment even in babies born at 37-38 weeks, considered “early term.

Children born between 32 and 36 weeks have a higher chance of language delay, with 222 per 1000 affected compared to 47 per 1000 for full-term children. Many delivered moderately preterm face lower educational attainment in primary school, impacting 300 per 1000 compared to 160 per 1000 for full-term children.

Though cerebral palsy risk is generally low, infants born at 32 to 33 weeks have a 14 times higher risk than full-term children. Challenges for children born between 32 and 38 weeks persist into high school, with an increased risk of cognitive impairment and lower educational achievement.

Lead author of the study, Dr. Katherine Pettinger from the Department of Health Sciences at the University of York, said: “It is important to remember that while our study shows an increase in risk for children born moderately early relative to their peers born at full term, many children will not experience any developmental problems.”

“The reasons behind our findings are unclear, but babies born just a few weeks early have different brain maturation to full-term children, and birth between 32 and 38 weeks’ gestation may disrupt the evolution of neural connections, potentially contributing to developmental disorder.”

Babies born moderately preterm may face long-term effects, especially when early delivery is necessary due to the mother’s health conditions like preeclampsia. Knowing these implications can influence decisions in obstetrics. It’s crucial for healthcare professionals, especially pediatricians, to be well-informed about the potential consequences. This ensures that families receive evidence-based information, preventing missed opportunities for early intervention.

Current guidelines suggest monitoring children born before 30 weeks until age two. Due to varied outcomes, the researchers caution against routine health appointments for those born between 32 and 38 weeks. Instead, they emphasize improved communication among schools, parents, and health professionals, advocating better support for teachers without placing undue strain on NHS services.

Dr. Pettinger said, “Being born just a few weeks early has lasting effects on primary school. Teachers should be informed about preterm and early-term students and receive training on supporting them. Further research is needed for large population studies to understand how developmental disorders relate to gestational age. Examining co-occurrence of disorders can guide tailored interventions for children.” 

In conclusion, recent research highlights that children born moderately early face a higher risk of developmental disorders. This finding emphasizes the importance of understanding and addressing the potential challenges these children may encounter in their development.

Journal reference:

  1. Katherine J. Pettinger, Clare Copper, et al., Risk of Developmental Disorders in Children Born at 32 to 38 Weeks Gestation: A Meta-Analysis. Pediatrics. DOI: 10.1542/peds.2023-061878.

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