title: Threatened preterm labor is a risk factor for impaired cognitive development in early childhood.
abstract: BACKGROUND
  Threatened preterm labor is a leading cause of hospital admission during pregnancy. Patients with an episode of threatened preterm labor who deliver at term are considered to have false preterm labor. However, threatened preterm labor has been proposed as a pathologic insult that is not always sufficient to induce irreversible spontaneous preterm birth but that could alter the normal course of pregnancy.
  
  
  OBJECTIVE
  The aim of this study was to evaluate threatened preterm labor during pregnancy as a risk factor of neurodevelopmental deficits of children at 2 years of age.
  
  
  METHODS
  Two-year-old children who were born late preterm (n=22) or at term after threatened preterm labor (n=23) were compared with at-term control children (n=42). Neurodevelopment was evaluated at a corrected age of 24-29 months with the use of the Merrill-Palmer-Revised Scales of Development.
  
  
  RESULTS
  Children who were born at term after threatened preterm labor had lower scores than control children on global cognitive index (95.4 vs 104.2; P=.011), cognition (95.1 vs 103.1; P=.021), fine motor (95.2 vs 103.4; P=.003), gross motor (84.7 vs 99.8; P=.001), memory (92.9 vs 100.4; P=.015), receptive language (93.9 vs 102.9; P=.03), speed of processing (105.7 vs 113.3; P=.011), and visual motor coordination (98.8 vs 106.7; P=.003) subtests. Children born at term after threatened preterm labor had an increased risk of mild neurodevelopmental delay compared with control children (odds ratio for global cognitive index, 2.06; 95% confidence interval, 1.09-3.88; P=.033). There were no significant differences in any cognitive domain between children who were born late preterm and children who were born at term after threatened preterm labor.
  
  
  CONCLUSIONS
  Threatened preterm labor is a risk factor for impaired cognitive development at 2 years of age, even if birth occurred at term.
authors: ISS Aragón, Obstetrics Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, University of Zaragoza, Zaragoza, Spain.
authors: Cristina
authors: C
authors: Paules
authors: ISS Aragón, Ophthalmology Department, Hospital Universitario Miguel Servet Zaragoza, University of Zaragoza, Zaragoza, Spain. Electronic address: vpueyo@unizar.es.
authors: Victoria
authors: V
authors: Pueyo
authors: ISS Aragón, Psychology Department, University of Zaragoza, Zaragoza, Spain.
authors: Elena
authors: E
authors: Martí
authors: ISS Aragón, Psychology Department, University of Zaragoza, Zaragoza, Spain.
authors: Susana
authors: S
authors: de Vilchez
authors: Integrated Research Center for Fetal Medicine, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD.
authors: Irina
authors: I
authors: Burd
authors: ISS Aragón, Obstetrics Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, University of Zaragoza, Zaragoza, Spain.
authors: Pilar
authors: P
authors: Calvo
authors: ISS Aragón, Obstetrics Department, Hospital Clínico Universitario Lozano Blesa, Zaragoza, University of Zaragoza, Zaragoza, Spain.
authors: Daniel
authors: D
authors: Oros
mesh_terms: D000328:Adult; D002657:Child Development; D002675:Child, Preschool; D003071:Cognition; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D065886:Neurodevelopmental Disorders / Q000453:epidemiology* / Q000523:psychology; D007752:Obstetric Labor, Premature / Q000453:epidemiology*; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology* / Q000523:psychology; D011446:Prospective Studies; D047929:Term Birth
keywords: neurodevelopment; preterm birth; threatened preterm labor