Gestational age at delivery correlates with special educational needs

January 01, 0001

Gestational age at delivery correlates with special educational needs

Previous studies have demonstrated an association between preterm delivery and increased risk of special educational need (SEN). The aim of this study was to examine the risk of SEN across the full range of gestation. The conducted a population-based, retrospective study by linking school census data on the 407,503 eligible school-aged children resident in 19 Scottish Local Authority areas (total population 3.8 million) to their routine birth data.

SEN was recorded in 17,784 (4.9%) children; 1,565 (8.4%) of those born preterm and 16,219 (4.7%) of those born at term. The risk of SEN increased across the whole range of gestation from 40 to 24 wk: 37-39 wk adjusted odds ratio (OR) 1.16; 33-36 wk adjusted OR 1.53; 28-32 wk adjusted OR 2.66; 24-27 wk adjusted OR 6.92. There was no interaction between elective versus spontaneous delivery. Overall, gestation at delivery accounted for 10% of the adjusted population attributable fraction of SEN. Because of their high frequency, early term deliveries (37-39 wk) accounted for 5.5% of cases of SEN compared with preterm deliveries (less than 37 wk), which accounted for only 3.6% of cases.

The researchers concluded: "Gestation age at delivery had a strong, dose-dependent relationship with SEN that was apparent across the whole range of gestation. Because early term delivery is more common than preterm delivery, the former accounts for a higher percentage of SEN cases. Our findings have important implications for clinical practice in relation to the timing of elective delivery."

The last sentence of the conclusion makes a very important point.


For the full abstract, click here.

PloS Medicine 7(6): e1000289, 8 June 2010 © 2010 MacKay et al
Gestational Age at Delivery and Special Educational Need: Retrospective Cohort Study of 407,503 Schoolchildren. Daniel F. MacKay, Gordon C. S. Smith, Richard Dobbie and Jill P. Pell. Correspondence to Jill Pell: [email protected]

Category: W. Pregnancy/Childbirth/Family Planning. Keywords: gestational age, delivery, special educational need, retrospective cohort, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 2 July 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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