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A study involving over one million children published in The BMJ sheds light on the higher long-term risks of neurodevelopmental difficulties faced by children born moderately (32-33 weeks) or late preterm (34-36 weeks). The findings emphasize that these risks, affecting behavior and learning abilities, should not be underestimated, as such children constitute approximately 80% of all preterm births. Understanding these risks can aid professionals and families in better assessing, planning follow-up care, and optimizing healthcare systems for children born moderately or late preterm.
Previous research indicates that children born early have elevated risks of neurodevelopmental and behavioral issues throughout childhood and adolescence compared to those born at term. However, limited population-based studies have delved into the long-term neurodevelopmental outcomes of moderately and late preterm births. The current study utilized Swedish national registry data to assess outcomes in these children compared to those born full term (39-40 weeks).
The study included 1,281,690 singleton children born in Sweden between 1998 and 2012, with outcomes measured up to age 16. The main outcomes of interest were motor impairment, cognitive impairment, epileptic impairment, visual impairment, hearing impairment, and a combination of any neurodevelopmental impairment. Factors considered included various maternal and infant-related variables, such as age, parity, body mass index during early pregnancy, and more.
The findings showed that, compared to children born full term, those born moderately or late preterm exhibited higher risks for any impairment, with motor impairment showing the highest relative risk. Risks for neurodevelopmental impairments were found to be highest from 32 weeks, gradually declining until 41 weeks, but remaining higher than full-term births. A sibling comparison analysis supported the stability of most associations.
While the study has limitations, such as its observational nature and potential under-reporting or misclassification of diagnoses, its large-scale, population-based design using high-quality national registries provides valuable insights. The study’s authors stress that the risks for adverse neurodevelopmental outcomes in moderately and late preterm births should not be underestimated, given their significant representation among preterm births.
Understanding and addressing the long-term risks associated with preterm birth can contribute to more effective risk assessment, follow-up care, and healthcare system planning for affected children and their families.
