Neurobehavioral development of 25 254 children with different gestational ages at birth in three cities of China

Abstract:

Objective To study the effect of gestational age at birth on the neurobehavioral development of preschool children. Methods A total of 25 254 preschool children from Ma'anshan of Anhui Province, Taizhou of Zhejiang Province, and Yangzhou of Jiangsu Province were enrolled. The preschool children were divided into three groups based on their gestational ages at birth:preterm group (2 760 cases; 28-36⁺⁶ weeks), early term group (6 005 cases; 37-38⁺⁶ weeks), and full term group (16 489 cases; ≥ 39 weeks). The Ages and Stages Questionnaires-Third Edition (ASQ-3) was employed to evaluate the children's neurobehavioral development. Results The preterm group had significantly lower scores of the five domains of ASQ-3, communication, gross motor, fine motor, problem solving, and personal-social, than the full term group (P < 0.05), and significantly lower scores of communication, gross motor, fine motor, and problem solving than the early term group (P < 0.05). There were no significant differences in the scores of the five domains of ASQ-3 between the early term and full term groups (P > 0.05). The multiple linear regression analysis indicated a significant positive correlation between gestational age and the five domains of ASQ-3 after adjustment for confounding factors including sex, age, body mass index, and parental education level (P < 0.01). Conclusions Children born preterm have poorer neurobehavioral development than those born full term and early term, whereas children born full term and early term have similar neurobehavioral development. Gestational age at birth is an independent influencing factor for neurobehavioral development in preschool children.