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Children born early at increased risk of developmental disorders

Photo of baby feet

Published: 08 December 2023

Children born early are more likely to have developmental disorders compared to children born at full term. This is according to a major new study funded by NIHR.

Researchers at the Universities of York, Leeds and Leicester carried out the study. They examined data from over 75 studies around the world. This involved over 8 million children.

It found around 7% of babies in the UK are born moderately early each year. They are more likely to have an increased risk of most development disorders. This includes:

  • language delay
  • cognitive impairment
  • ADHD
  • cerebral palsy

Whilst risks decreased with each week of gestation, there was still evidence of a small increase in risk of several developmental disorders even when children were born between 37-38 weeks.

Language disorder most common delay

One of the most common disorders was language delay. This affected 222 per 1000 children born between 32-36 weeks. In comparison, it affected 47 per 1000 for full term children (born at 37 weeks).

Research found many children face low educational attainment during the primary school years. This affects 300 per 1000 children born moderately preterm. In comparison, it affected 160 per 1000 children born at full term.

The risk of cerebral palsy is low for all children. But results found it is 14 times higher for infants born at 32-33 weeks compared with children born at full term.

The study found difficulties faced by children born at 32-38 weeks persist through childhood into the high school years.

Lead author of the study, Dr Katherine Pettinger, from the Department of Health Sciences at the University of York and funded by a NIHR Doctoral Fellowship, said: “It is important to remember that whilst our study shows an increase in risk for children born moderately early relative to their peers born at full term, many children will not experience any developmental problems.

“The reasons behind our findings are not yet clear, but babies born just a few weeks early have different brain maturation to full term children, and it is possible that birth between 32 and 38 weeks’ gestation may disrupt evolution of neural connections, potentially contributing to developmental disorder.

“Many babies that are born moderately preterm are delivered early for very good reasons, for example when the mother has a health condition such as preeclampsia. However, understanding the long-term implications of birth before full term may influence obstetric decision making in some cases.

"It is also vital that all healthcare professionals, and particularly paediatricians, are well informed of the potential consequences of preterm birth so that they can give evidence based information to families and so opportunities for early intervention are not missed. ”

Current guidelines and research advice

National Institute for Health and Care Excellence guidelines say children should be monitored up until 2-years-old if they were born before the age of 30 weeks.

However, researchers don't recommend all children born between 32-38 weeks’ gestation receive multiple routine health appointments. Many won't show signs of developmental disorders and it would place strain on the NHS.

Researchers say more communication is needed between schools, parents and health professionals. They also say teachers need better support.

Dr Pettinger added: “The data tells us the effects of being just a few weeks early are still there at primary school age. It therefore makes sense for teachers to be informed if they have students who are born preterm and early term and receive training on how to support them.

“Further research is now needed to look at large scale population studies to explore how incidents of developmental disorders relate to gestational age and see if the patterns we observed in the present study are replicated. We also want to look at whether children are commonly affected by more than one disorder, as understanding which conditions are likely to co-occur can help to produce more tailored interventions for children.”

Read the study published in the Pediatrics journal.

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