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327 Antenatal Factors Associated with Developmental Delay in Moderately Preterm-Born Children, Results of a Cohort Study
  1. J Kerstjens1,
  2. AF Winter de2,
  3. KM Sollie3,
  4. MR Potijk2,
  5. IF BoccaTjeertes1,
  6. SA Reijneveld2,
  7. AF Bos, Lollipop1
  1. 1Neonatology, Beatrix Children’s Hospital, University of Groningen, University Medical Center Groningen
  2. 2Health Sciences, University Medical Center Groningen, University of Groningen
  3. 3Obstetrics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

Abstract

Background Worldwide 6–9% of all children are born moderately preterm (32+ 0–35+ 6 weeks’ gestation). They are at risk for developmental delay in early childhood. Knowledge on the influence of antenatal maternal, fetal, and delivery-related factors on the development of moderately preterm-born children is limited.

Objective To determine the association between developmental delay in early childhood and antenatal factors in moderately preterm-born children.

Design/methods We measured development with the Ages and Stages Questionnaire (ASQ) at age 43–49 months in 834 moderate preterms born in 2002–2003, in a community-based cohort study.

A total ASQ score > 2SD below the Dutch mean reference was considered to indicate developmental delay. Data on maternal, fetal, and delivery-related factors were obtained from medical records. We used logistic regression to estimate odds ratios (ORs) for developmental delay, adjusted for socio-demographic variables.

Results In univariate analyses, several fetal and maternal factors were associated with risk of developmental delay. In multivariate analyses, only pre-existent obesity (odds ratio (OR) 3.0, 95% confidence interval (CI): 1.5–5.8), multiparity (OR:2.8, CI: 1.6–4.9), Small-for-gestational-age (SGA) (OR:2.9, CI: 1.4–6.1), multiple pregnancy (OR:1.8, CI: 1.0–3.3), and male gender (OR:4.1, CI: 2.2–8.6) increased risk of developmental delay.

Conclusions Of all antenatal factors studied, no modifiable factors were associated with developmental delay except for SGA. Enhanced prevention of intra-uterine growth restriction, interventions aiming at reducing pre-pregnancy weight in fertile women, and reducing number of transferred embryos in assisted reproduction might offer routes to improve developmental outcomes in children eventually born moderately preterm.

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