Association of birthweight centiles and early childhood development of singleton infants born from 37 weeks of gestation in Scotland: A population-based cohort study

Autor: Abiodun Adanikin, Deborah A. Lawlor, Jill P. Pell, Scott M. Nelson, Gordon C. S. Smith, Stamatina Iliodromiti
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: PLoS Medicine, Vol 19, Iss 10 (2022)
Druh dokumentu: article
ISSN: 1549-1277
1549-1676
Popis: Background Birthweight centiles beyond the traditional thresholds for small or large babies are associated with adverse perinatal outcomes but there is a paucity of data about the relationship between birthweight centiles and childhood development among children born from 37 weeks of gestation. This study aims to establish the association between birthweight centiles across the whole distribution and early childhood development among children born from 37 weeks of gestation. Methods and findings This is a population-based cohort study of 686,284 singleton infants born from 37 weeks of gestation. The cohort was generated by linking pregnancy and delivery data from the Scottish Morbidity Records (2003 to 2015) and the child developmental assessment at age 2 to 3.5 years. The main outcomes were child’s fine motor, gross motor, communication, and social developmental concerns measured with the Ages and Stages Questionnaires—3 (ASQ-3) and Ages and Stages Questionnaire: Social & Emotional—2 (ASQ:SE-2), and for a subset of children with additional specialist tools such as the Modified Checklist for Autism in Toddlers (M-CHAT) if the ASQ3/SE indicate these are necessary. The ASQ score for each domain was categorised as “concern” and “no concern.” We used multivariate cubic regression splines to model the associations between birthweight centiles and early childhood developmental concerns. We used multivariate Poisson regression models, with cluster robust errors, to estimate the relative risks (RRs) of developmental concerns below and above the established thresholds. We adjusted for maternal age, early pregnancy body mass index (BMI), parity, year of delivery, gestational age at delivery, smoking history, substance misuse in pregnancy, alcohol intake, ethnicity, residential area deprivation index, maternal clinical conditions in pregnancy (such as diabetes and pre-eclampsia), induction of labour, and child’s sex. Babies born from 37 weeks of gestation with birthweight below the 25th centile, compared to those between the 25th and 74th centile, were at higher risk of developmental concerns. Those born between the 10th and 24th centile had an RR of 1.07 (95% CI: 1.03 to 1.12, p < 0.001), between the 3rd and 9th centile had an RR: 1.18 (95% CI: 1.12 to 1.25, p < 0.001), and Conclusions We observed that from 37 weeks of gestation birthweight below the 25th centile was associated with child developmental concerns, with an association apparent at higher centiles above the conventional threshold defining small for gestational age (SGA, 3rd or 10th centile). Mild to moderate SGA is an unrecognised potentially important contributor to the prevalence of developmental concerns. Closer surveillance, appropriate parental counselling, and increased support during childhood may reduce the risks associated with lower birthweight centiles. In a population-based cohort study in Scotland, Abiodun Adanikin and colleagues study the association of birthweight centiles and motor, communication, and social developmental concerns identified at ages 2 to 3.5 years of age. Author summary Why was this study done? Existing studies investigating the association between birthweight centiles and childhood developmental concerns have focused mainly either on preterm babies or use established birthweight thresholds. We know little on how distribution of birthweights, across its entire range, associate with early childhood developmental concerns among infants born from 37 weeks of gestation. What did the researchers do and find? We analysed routinely collected maternity and delivery records of 686,284 singleton infants born from 37 weeks of gestation in Scotland between 2003 and 2015. Among these infants, we found that the association of birthweight with early childhood developmental concerns was apparent at higher centiles than the conventional threshold defining small for gestational age (What do these findings mean? Although it is mostly unrecognised, mild to moderate small for gestational age (SGA) may be a key contributor to the burden of developmental concerns. Babies who had mild to moderate SGA may need closer monitoring and increased support in early childhood to reduce the risk of developmental concerns.
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