title: Mild prematurity, proximal social processes, and development.
abstract: OBJECTIVE
  To elucidate the role of gestational age in determining the risk of poor developmental outcomes among children born late preterm (34-36 weeks) and early term (37-38 weeks) versus full term (39-41 weeks) by examining the contribution of gestational age to these outcomes in the context of proximal social processes.
  
  
  METHODS
  This was an analysis of the Canadian National Longitudinal Survey of Children and Youth. Developmental outcomes were examined at 2 to 3 (N= 15099) and 4 to 5 years (N= 12302). The sample included singletons, delivered at 34 to 41 weeks, whose respondents were their biological mothers. Multivariable modified Poisson regression was used to directly estimate adjusted relative risks (aRRs). We assessed the role of parenting by using moderation analyses.
  
  
  RESULTS
  In unadjusted analyses, children born late preterm appeared to have greater risk for developmental delay (relative risk = 1.26; 95% confidence interval [CI], 1.01 to 1.56) versus full term. In adjusted analyses, results were nonsignificant at 2 to 3 years (late preterm aRR = 1.13; 95% CI, 0.90 to 1.42; early term aRR = 1.11; 95% CI, 0.96 to 1.27) and 4 to 5 years (late preterm aRR = 1.06; 95% CI, 0.79 to 1.43; early term aRR = 1.03; 95% CI, 0.85 to 1.25). Parenting did not modify the effect of gestational age but was a strong predictor of poor developmental outcomes.
  
  
  CONCLUSIONS
  Our findings show that, closer to full term, social factors (not gestational age) may be the most important influences on development.
authors.affiliation: Departments of Epidemiology and Biostatistics, Karen.Campbell@schulich.uwo.ca.
authors.forename: Hilary K
authors.initials: HK
authors.lastname: Brown
authors.affiliation: Departments of Epidemiology and Biostatistics, Paediatrics, and.
authors.forename: Kathy Nixon
authors.initials: KN
authors.lastname: Speechley
authors.affiliation: Departments of Epidemiology and Biostatistics.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Macnab
authors.affiliation: Obstetrics and Gynaecology, The University of Western Ontario, London, Ontario, Canada.
authors.forename: Renato
authors.initials: R
authors.lastname: Natale
authors.affiliation: Departments of Epidemiology and Biostatistics, Paediatrics, and Obstetrics and Gynaecology, The University of Western Ontario, London, Ontario, Canada.
authors.forename: M Karen
authors.initials: MK
authors.lastname: Campbell
mesh_terms: D002675:Child, Preschool; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology* / Q000523:psychology; D008137:Longitudinal Studies; D008297:Male; D016487:Parenting / Q000523:psychology; D012919:Social Behavior
keywords: child development; parenting; preterm birth