Increased Risk of Adverse Neurological Development for Late Preterm Infants
Received 20 February 2008; received in revised form 14 July 2008; accepted 8 August 2008. published online 11 December 2008.
Refers to article:
Late Preterm Birth: Appreciable Risks, Rising Incidence
, 11 December 2008
Michael S. Kramer
The Journal of Pediatrics
February 2009 (Vol. 154, Issue 2, Pages 159-160) Full Text |
Full-Text PDF (72 KB)
Objective
To assess the risks of moderate prematurity for cerebral palsy (CP), developmental delay/mental retardation (DD/MR), and seizure disorders in early childhood.
Study design
Retrospective cohort study using hospitalization and outpatient databases from the Northern California Kaiser Permanente Medical Care Program. Data covered 141 321 children ≥30 weeks born between Jan 1, 2000, and June 30, 2004, with follow-up through Jun 30, 2005. Presence of CP, DD/MR, and seizures was based on International Classification of Diseases, Ninth Revision codes identified in the encounter data. Separate Cox proportional hazard models were used for each of the outcomes, with crude and adjusted hazard ratios calculated for each gestational age group.
Results
Decreasing gestational age was associated with increased incidence of CP and DD/MR, even for those born at 34 to 36 weeks gestation. Children born late preterm were >3 times as likely (hazard ratio, 3.39; 95% CI, 2.54-4.52) as children born at term to be diagnosed with CP. A modest association with DD/MR was found for children born at 34 to 36 weeks (hazard ratio, 1.25; 95% CI, 1.01-1.54), but not for children in whom seizures were diagnosed.
Conclusions
Prematurity is associated with long-term neurodevelopmental consequences, with risks increasing as gestation decreases, even in infants born at 34 to 36 weeks.
aPerinatal Data Center, March of Dimes National Office, White Plains, NY
bDepartment of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine, Bronx, NY
cDepartment of Society, Human Development and Health, Harvard School of Public Health, Boston, MA
dDivision of Research, Perinatal Research Unit, Kaiser Permanente Medical Care Program, Oakland, CA
eDepartment of Pediatrics, Columbia University Medical Center, New York, NY
fDepartment of Pediatrics, Kaiser Permanente Medical Center, Walnut Creek, CA
Reprint requests: Joann R. Petrini, PhD, MPH, Perinatal Data Center, March of Dimes National Office, 1275 Mamaroneck Ave, White Plains, NY 10605
This research was supported by the March of Dimes, The Permanente Medical Group, Inc. and Kaiser Foundation Hospitals, Inc. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the affiliated agencies. The authors declare no conflicts of interest.
ABSTRACT