Association of gestational age at birth with subsequent suspected developmental coordination disorder in early childhood

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Hua, J., Barnett, A.L., Williams, G.J. ORCID: 0000-0001-7689-1231, Dai, X., Sun, Y., Li, H., Chen, G., Wang, L., Feng, J., Liu, Y., Zhang, L., Zhu, L., Weng, T., Guan, H., Gu, Y., Zhou, Y., Butcher, A. and Du, W. ORCID: 0000-0002-5115-7214, 2021. Association of gestational age at birth with subsequent suspected developmental coordination disorder in early childhood. JAMA Network Open, 4 (12): e2137581. ISSN 2574-3805

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Official URL: https://doi.org/10.1001/jamanetworkopen.2021.37581

Abstract

Importance: It remains unknown whether children born at different degrees of prematurity, early term, and post term might have a higher risk of developmental coordination disorder (DCD) compared with completely full-term children (39-40 gestational weeks).

Objective: To differentiate between suspected DCD in children with different gestational ages based on a national representative sample in China.

Design, Setting, and Participants: A retrospective cohort study was conducted in China from April 1, 2018, to December 31, 2019. A total of 152 433 children aged 3 to 5 years from 2403 public kindergartens in 551 cities of China were included in the final analysis. A multilevel regression model was developed to determine the strength of association for different gestational ages associated with suspected DCD when considering kindergartens as clusters.

Main Outcomes and Measures: Children’s motor performance was assessed using the Little Developmental Coordination Disorder Questionnaire, completed by their parents. Gestational age was determined according to the mother’s medical records and divided into 7 categories: completely full term (39 to 40 weeks’ gestation), very preterm (41 weeks).

Results: A total of 152 433 children aged 3 to 5 years (mean [SD] age, 4.5 [0.8] years), including 80 370 boys (52.7%) and 72 063 girls (47.3%), were included in the study. There were 45 052 children (29.6%) aged 3 years, 59 796 (39.2%) aged 4 years, and 47 585 (31.2%) aged 5 years. Children who were born very preterm (odds ratio [OR], 1.35; 95% CI, 1.23-1.48), moderately preterm (OR, 1.18; 95% CI, 1.02-1.36), late preterm (OR, 1.24; 95% CI, 1.16-1.32), early term (OR, 1.11; 95% CI, 1.06-1.16), and post term (OR, 1.17; 95% CI, 1.07-1.27) were more likely to be classified in the suspected DCD category on the Little Developmental Coordination Disorder Questionnaire than completely full-term children after adjusting for the same characteristics. Additionally, there was no association with suspected DCD in younger (aged 3 years) early-term and postterm children by stratified analyses.

Conclusions and Relevance: In this cohort study, every degree of prematurity at birth, early-term birth, and postterm birth were associated with suspected DCD when compared with full-term birth. These findings have important implications for understanding motor development in children born at different gestational ages. Long-term follow-up and rehabilitation interventions should be considered for children born early and post term.

Item Type:

Journal article

Publication Title:

JAMA Network Open

Creators:

Hua, J., Barnett, A.L., Williams, G.J., Dai, X., Sun, Y., Li, H., Chen, G., Wang, L., Feng, J., Liu, Y., Zhang, L., Zhu, L., Weng, T., Guan, H., Gu, Y., Zhou, Y., Butcher, A. and Du, W.

Publisher:

American Medical Association (AMA)

Date:

14 December 2021

Volume:

Number:

ISSN:

2574-3805

Identifiers: