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.