Jason P Bentley1, Francisco J Schneuer2, Samantha J Lain2, Andrew J Martin3, Adrienne Gordon4,5, Natasha Nassar2. 1. Menzies Centre for Health Policy, School of Public Health, and jason.bentley@sydney.edu.au. 2. Menzies Centre for Health Policy, School of Public Health, and. 3. School of Education, University of New South Wales, Sydney, New South Wales, Australia; and. 4. Discipline of Obstetrics, Gynaecology, and Neonatology, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia. 5. Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.
Abstract
OBJECTIVES: Investigate the association between severe neonatal morbidity (SNM) and child development and school performance among term infants. METHODS: The study population included term infants without major congenital conditions born between 2000 and 2007 in New South Wales, Australia, with a linked record of developmental assessment at ages 4 to 6 years in 2009 or 2012 (n = 144 535) or school performance at ages 7 to 9 years from 2009 to 2014 (n = 253 447). Developmental outcomes included special needs or being vulnerable and/or at risk in 1 of 5 developmental domains. School performance outcomes were test exemption, or performing <-1 SD on reading or numeracy tests. Binary generalized estimating equations were used to estimate associations between SNM and outcomes, adjusting for sociodemographic, perinatal, and assessment and/or test characteristics. RESULTS: Overall, 2.1% of infants experienced SNM. The adjusted odds ratio (95% confidence interval) for SNM and physical health was 1.18 (1.08-1.29), 1.14 (1.02-1.26) for language and cognitive skills, and 1.14 (1.06-1.24) and 1.13 (1.05-1.21) for scoring <-1 SD in reading and numeracy, respectively. SNM was most strongly associated with special needs 1.34 (1.15-1.55) and test exemption 1.50 (1.25-1.81). SNM infants born at 37 to 38 weeks' gestation and who were small for gestational age had the greatest likelihood of poorer outcomes. CONCLUSIONS: Term infants with SNM have greater odds of poor neurodevelopment in childhood. These findings provide population-based information for families and can inform clinical counseling and guidelines for follow-up and early intervention.
OBJECTIVES: Investigate the association between severe neonatal morbidity (SNM) and child development and school performance among term infants. METHODS: The study population included term infants without major congenital conditions born between 2000 and 2007 in New South Wales, Australia, with a linked record of developmental assessment at ages 4 to 6 years in 2009 or 2012 (n = 144 535) or school performance at ages 7 to 9 years from 2009 to 2014 (n = 253 447). Developmental outcomes included special needs or being vulnerable and/or at risk in 1 of 5 developmental domains. School performance outcomes were test exemption, or performing <-1 SD on reading or numeracy tests. Binary generalized estimating equations were used to estimate associations between SNM and outcomes, adjusting for sociodemographic, perinatal, and assessment and/or test characteristics. RESULTS: Overall, 2.1% of infants experienced SNM. The adjusted odds ratio (95% confidence interval) for SNM and physical health was 1.18 (1.08-1.29), 1.14 (1.02-1.26) for language and cognitive skills, and 1.14 (1.06-1.24) and 1.13 (1.05-1.21) for scoring <-1 SD in reading and numeracy, respectively. SNM was most strongly associated with special needs 1.34 (1.15-1.55) and test exemption 1.50 (1.25-1.81). SNM infants born at 37 to 38 weeks' gestation and who were small for gestational age had the greatest likelihood of poorer outcomes. CONCLUSIONS: Term infants with SNM have greater odds of poor neurodevelopment in childhood. These findings provide population-based information for families and can inform clinical counseling and guidelines for follow-up and early intervention.