We opted to investigate whether a critical threshold exists for long-term pediatric neurological morbidity, and cerebral palsy (CP), in preterm delivery, via a population-based cohort analysis. Four study groups were classified according to their gestational age at birth: 24–27.6, 28–31.6, 32–36.6 weeks and term deliveries, evaluating the incidence of long-term hospitalizations of the offspring due to neurological morbidity. Cox proportional hazard models were performed to control for confounders. A Kaplan–Meier survival curve was used to compare the cumulative neurological morbidity incidence for each group. A total of 220,563 deliveries were included: 0.1% (118) occurred at 24–27.6 weeks of gestation, 0.4% (776) occurred at 28–31.6 weeks of gestation, 6% (13,308) occurred at 32–36.6 weeks of gestation and 93% (206,361) at term. In a Cox model, while adjusting for confounders, delivery before 25 weeks had a 3.9-fold risk for long-term neurological morbidity (adjusted HR (hazard ratio) = 3.9, 95% CI (confidence interval) 2.3–6.6; p < 0.001). The Kaplan–Meier survival curve demonstrated a linear association between long-term neurological morbidity and decreasing gestational age. In a second Cox model, adjusted for confounders, infants born before 25 weeks of gestation had increased rates of CP (adjusted HR = 62.495% CI 25.6–152.4; p < 0.001). In our population, the critical cut-off for long-term neurological complications is delivery before 25 weeks gestation.

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OBJECTIVE: To evaluate whether offspring of women delivering at a young age (<17 years old) are at an increased risk for long-term pediatric morbidity. STUDY DESIGN: A retrospective population-based cohort study comparing singleton deliveries of women at different ages who delivered between the years 1991 and 2014 was conducted. Women were classified into three groups: < 17 years, 18e20 years, and a comparison group of 21-35 years old. The incidence of long-term (up to the age of 18 years) hospitalizations of the offspring due to cardiovascular, endocrine, hematological and respiratory morbidity was evaluated in the three maternal age groups. Multiple pregnancies ajog.org