Late-Preterm Birth and Its Association With Cognitive and Socioemotional Outcomes at 6 Years of Age

Talge, Nicole M.; Holzman, Claudia; Wang, Jianling; Lucia, Victoria C.; Gardiner, Joseph C.; Breslau, Naomi

doi:10.1542/peds.2010-1536

Cited by 242 publications

(152 citation statements)

References 53 publications

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“…Ces nouveau-né s sont 3 fois plus susceptibles de dé cé der avant leur premier anniversaire et 6 fois plus susceptibles de dé cé der dans leur premiè re semaine de vie [12]. La pré maturité tardive est associé e à des problè mes de comportement et un QI plus faible à l'âge de 6 ans, indé pendamment du QI maternel, du cadre de vie et des donné es sociodé mographiques [13].…”

Section: Discussionunclassified

Prématurité modérée 34–37SA : description des causes et conséquences néonatales immédiates dans une maternité de niveau 2

Valery

Picone

Coatantiec

et al. 2015

Gynécologie Obstétrique & Fertilité

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Section: Discussionunclassified

Prématurité modérée 34–37SA : description des causes et conséquences néonatales immédiates dans une maternité de niveau 2

Valery

Picone

Coatantiec

et al. 2015

Gynécologie Obstétrique & Fertilité

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“…These associations are also borne out in other studies in which resuscitation at birth, sociodemographic factors and pre-eclampsia, in particular, have been independently associated with long-term outcomes in this population. 175,199,200 Not receiving any breast milk at discharge, either expressed or by breastfeeding, was associated with disability at 2 years. The impact of breastfeeding on infant development has been widely reported, although the mechanisms for this association remain unclear in both term-born and preterm infants.…”

Section: Discussionmentioning

confidence: 99%

Towards reducing variations in infant mortality and morbidity: a population-based approach

Field

Boyle

Draper

et al. 2016

Programme Grants Appl Res

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BackgroundOur aims were (1) to improve understanding of regional variation in early-life mortality rates and the UK’s poor performance in international comparisons; and (2) to identify the extent to which late and moderately preterm (LMPT) birth contributes to early childhood mortality and morbidity.ObjectiveTo undertake a programme of linked population-based research studies to work towards reducing variations in infant mortality and morbidity rates.DesignTwo interlinked streams: (1) a detailed analysis of national and regional data sets and (2) establishment of cohorts of LMPT babies and term-born control babies.SettingCohorts were drawn from the geographically defined areas of Leicestershire and Nottinghamshire, and analyses were carried out at the University of Leicester.Data sourcesFor stream 1, national data were obtained from four sources: the Office for National Statistics, NHS Numbers for Babies, Centre for Maternal and Child Enquiries and East Midlands and South Yorkshire Congenital Anomalies Register. For stream 2, prospective data were collected for 1130 LMPT babies and 1255 term-born control babies.Main outcome measuresDetailed analysis of stillbirth and early childhood mortality rates with a particular focus on factors leading to biased or unfair comparison; review of clinical, health economic and developmental outcomes over the first 2 years of life for LMPT and term-born babies.ResultsThe deprivation gap in neonatal mortality has widened over time, despite government efforts to reduce it. Stillbirth rates are twice as high in the most deprived as in the least deprived decile. Approximately 70% of all infant deaths are the result of either preterm birth or a major congenital abnormality, and these are heavily influenced by mothers’ exposure to deprivation. Births at < 24 weeks’ gestation constitute only 1% of all births, but account for 20% of infant mortality. Classification of birth status for these babies varies widely across England. Risk of LMPT birth is greatest in the most deprived groups within society. Compared with term-born peers, LMPT babies are at an increased risk of neonatal morbidity, neonatal unit admission and poorer long-term health and developmental outcomes. Cognitive and socioemotional development problems confer the greatest long-term burden, with the risk being amplified by socioeconomic factors. During the first 24 months of life each child born LMPT generates approximately £3500 of additional health and societal costs.ConclusionsHealth professionals should be cautious in reviewing unadjusted early-life mortality rates, particularly when these relate to individual trusts. When more sophisticated analysis is not possible, babies of < 24 weeks’ gestation should be excluded. Neonatal services should review the care they offer to babies born LMPT to ensure that it is appropriate to their needs. The risk of adverse outcome is low in LMPT children. However, the risk appears higher for some types of antenatal problems and when the mother is from a deprived background.Future workFuture work could include studies to improve our understanding of how deprivation increases the risk of mortality and morbidity in early life and investigation of longer-term outcomes and interventions in at-risk LMPT infants to improve future attainment.FundingThe National Institute for Health Research Programme Grants for Applied Research programme.

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“…Studies of children at 342 and 643 years showed increased cognitive impairment and behavioural problems in late preterm infants compared with babies of ≥37 weeks. However, Baron et al 44 have since published data suggesting that uncomplicated late preterm birth does not, in itself, increase the risk of later cognitive impairment.…”

Section: Long-term Outcomesmentioning

confidence: 99%

“…A large number of infants born at 32 weeks and above are offered neither neonatal nor neurodevelopmental follow-up. Many now suggest that this may not be appropriate and recommend follow-up until at least 18 months of age,38 43 48 60 but the service implications of a change in favour of this approach are substantial. Most available data are focused on late preterm birth and data for deliveries at 32–33 weeks of gestation are particularly sparse.…”

Section: Implications For Clinical Practice Research and Public Healthmentioning

confidence: 99%

Born just a few weeks early: does it matter?

Boyle

2011

Arch Dis Child Fetal Neonatal Ed

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Until recently, infants born at moderate preterm (32-33 weeks) and late preterm (34-36 weeks) gestations have gone largely unstudied. Since their outcomes were thought to be similar to those of infants born at 37 weeks and above, they have historically been managed in much the same way as infants born at term. However, accumulating data indicate that risks of morbidity and mortality are significantly greater in this group than previously believed. Since moderate and late preterm infants account for around 6% of all births, very large numbers of babies are potentially affected. Although their problems may be less obvious than those of extremely preterm infants, the population impact of long-term health and neurodevelopmental problems in this group will be substantial. This review summarises the current available literature, highlights gaps in knowledge and discusses the implications of late preterm birth for both clinical practice and research in the perinatal period and beyond.

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Late-Preterm Birth and Its Association With Cognitive and Socioemotional Outcomes at 6 Years of Age

Cited by 242 publications

References 53 publications

Prématurité modérée 34–37SA : description des causes et conséquences néonatales immédiates dans une maternité de niveau 2

Prématurité modérée 34–37SA : description des causes et conséquences néonatales immédiates dans une maternité de niveau 2

Towards reducing variations in infant mortality and morbidity: a population-based approach

Born just a few weeks early: does it matter?

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