Low weight gain in pregnancy was associated with increased risk of preterm delivery, particularly if women were underweight or of average weight before pregnancy.
Purpose
Although previous studies demonstrate associations between adverse perinatal outcomes and developmental disabilities (DDs), study of population impacts is limited.
Methods
We computed relative risks adjusted (aRRs) for sociodemographic factors and component and summary population attributable fractions (PAFs) for associations between very low birth weight (VLBW, all preterm births), moderately low birth weight (MLBW) + Preterm, MLBW at term, and normal birth weight (NBW) + Preterm and seven DDs (cerebral palsy [CP], autism spectrum disorder [ASD], intellectual disability [ID], behavioral-conduct disorders, attention-deficit-hyperactivity disorder [ADHD], learning disability [LD], and other developmental delay) among children aged 3–17 years in the 2011–2012 National Survey of Children’s Health.
Results
VLBW-Preterm, MLBW-Preterm and NBW-Preterm were strongly to moderately associated with CP (aRRs: 43.5, 10.1, and 2.2, respectively; all significant) and also associated with ID, ASD, LD, and other developmental delay (aRR ranges: VLBW-Preterm 2.8–5.3; MLBW-Preterm 1.9–2.8; and NBW-Preterm 1.6–2.3). Summary PAFs for preterm birth and/or LBW were 55% for CP, 10%–20% for ASD, ID, LD, and other developmental delay, and less than 5% for ADHD and behavioral-conduct disorders. Findings were similar whether we assessed DDs as independent outcomes or within mutually exclusive categories accounting for DD co-occurrence.
Conclusions
Preterm birth has a sizable impact on child neurodevelopment. However, relative associations and population impacts vary widely by DD type.
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