Gestational Age, Ethnicity, and Associations with Developmental Disorders

Children born extremely preterm (<28 weeks gestation) are at risk of developmental disorders. There has been less research into outcomes of children born moderately preterm (32-33 weeks), late preterm (34–36 weeks), and early term (37-38 weeks). This means parents, clinicians, and educational professionals do not have access to accurate information about the likelihood of developmental disorders. Anticipating the disorders children are most at risk of could facilitate efficient diagnosis and service planning.
A systematic review showed that there was increased risk of most developmental disorders among moderately preterm children, but also late preterm and early term children, compared with term born children. There was little UK data on outcomes of children from minoritised ethnic groups born preterm. This informed two studies using Born in Bradford data. The first was the most comprehensive UK study of the full range of developmental disorders in relation to gestational age. Birth before full-term was associated with increased odds of developmental disorder which persisted after adjusting for covariates and in stratified analysis of Asian children; important since birth before full-term is more common among minoritised ethnic groups. The most common developmental disorder varied with ethnicity; compared to Asian children, White children had higher rates of autism spectrum disorder, but lower incidence of learning disabilities. Latent class analysis revealed most children (95.2%) had "typical development" with low risk of developmental disorders. The remainder were classified into: “Social, emotional, behavioural, and communication difficulties’’ (1.4%); “Educational difficulties” (2.6%); “Early developmental impairment, with physical and intellectual disabilities” (0.8%). The latter two groups were associated with birth before full-term.
Children with additive risk factors may benefit from additional follow-up. Children born late preterm and early term are at particular risk of educational difficulties (e.g. dyslexia and dyscalculia), reinforcing the need for better integration of health and education services.