title: Planned Birth Before 39 Weeks and Child Development: A Population-Based Study.
abstract: To investigate the association of gestational age and mode of birth with early child development.
  
  
  
  Population-based record linkage cohort study was conducted among 153 730 live-born infants of ≥32 weeks' gestation with developmental assessments at school age, in New South Wales, Australia, 2002 to 2007. Children were assessed in 5 domains: physical health and well-being, language and cognition, social competence, emotional maturity, and general knowledge and communication. Children scoring in the bottom 10% of national domains were considered developmentally vulnerable, and children developmentally vulnerable for ≥2 domains were classified as developmentally high risk (DHR), the primary outcome. Robust multivariable Poisson models were used to obtain individual and combined adjusted relative risks (aRRs) of gestational age and mode of birth for DHR children.
  
  
  
  Overall, 9.6% of children were DHR. The aRR (95% confidence interval) of being DHR increased with decreasing gestational age (referent: 40 weeks); 32 to 33 weeks 1.25 (1.08-1.44), 34 to 36 weeks 1.26 (1.18-1.34), 37 weeks 1.17 (1.10-1.25), 38 weeks 1.06 (1.01-1.10), 39 weeks 0.98 (0.94-1.02), ≥41 weeks 0.99 (0.94-1.03), and for labor induction or prelabor cesarean delivery (planned birth; referent: vaginal birth after spontaneous labor), 1.07 (1.04-1.11). The combined aRR for planned birth was 1.26 (1.18-1.34) at 37 weeks and 1.13 (1.08-1.19) at 38 weeks.
  
  
  
  Early (at <39 weeks) planned birth is associated with an elevated risk of poor child development at school age. The timing of planned birth is modifiable, and strategies to inform more judicious decision-making are needed to ensure optimal child health and development.
authors.affiliation: Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, New South Wales, Australia; jason.bentley@sydney.edu.au.|Sydney Medical School Northern and.|Menzies Centre for Health Policy, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Jason P
authors.initials: JP
authors.lastname: Bentley
authors.affiliation: Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, New South Wales, Australia.|Sydney Medical School Northern and.
authors.forename: Christine L
authors.initials: CL
authors.lastname: Roberts
authors.affiliation: Department of Neonatology, Royal North Shore Hospital, St Leonards, New South Wales, Australia; and.
authors.forename: Jenny R
authors.initials: JR
authors.lastname: Bowen
authors.affiliation: School of Education, The University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Martin
authors.affiliation: Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, New South Wales, Australia.|Sydney Medical School Northern and.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Morris
authors.affiliation: Menzies Centre for Health Policy, Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Natasha
authors.initials: N
authors.lastname: Nassar
mesh_terms: D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D002658:Developmental Disabilities / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007751:Labor, Induced / Q000009:adverse effects*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009517:New South Wales; D010347:Patient Care Planning; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth; D011295:Prenatal Care / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment