Research published this week in PLoS Medicine shows that there is an association between gestation of a baby at delivery and the risk of special educational needs in later life. This finding has important implications for the timing of elective Caesarean deliveries.
Children with special educational needs (SEN) may have either a learning difficulty (for example, dyslexia or autism) or a physical difficulty (such as deafness or poor vision) that requires special educational help. Although its already well-known that a baby born prematurely (for example 24 weeks of gestation) is more likely to have an SEN later in life than one born at full term (40 weeks of gestation) the risks of SEN in later life for babies born across a whole range of gestation ( from 24-40 weeks) has not previously been investigated.
By analyzing the birth history of a cohort of more than 400,000 schoolchildren from Scotland, Jill Pell and colleagues show that compared to children born at 40 weeks, children born at 37 weeks of gestation were 1.16 times as likely to have an SEN. Although the risk of SEN was much higher in preterm than in early term babies, because many more children were born between 37 and 39 weeks (about a third of babies) than before 37 weeks (one in 20 babies), early term births accounted for 5.5% of cases of SEN whereas preterm deliveries accounted for only 3.6% of cases.
These results show that even a baby born at 39 weeks--the normal timing for elective deliveries these days--has an increased risk of SEN compared with a baby born a week later.
Funding: The study was funded by a project grant from NHS Health Scotland. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Competing Interests: The authors have declared that no competing interests exist.
Citation: MacKay DF, Smith GCS, Dobbie R, Pell JP (2010) Gestational Age at Delivery and Special Educational Need: Retrospective Cohort Study of 407,503 Schoolchildren. PLoS Med 7(6): e1000289. doi:10.1371/journal.pmed.1000289
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