At term delivery’s impact on neuropsychiatric outcomes

Previous research has shown that births that are preterm and postterm are linked to adverse neuropsychiatric outcomes. Whether variation in gestational age for deliveries at term also has a linked with neurodevelopment has remained less well studied. A new investigation in JAMA Pediatrics tries to offer some information.¹

The investigators ran a population-based cohort study that included pregnant women who were living in Rotterdam, the Netherlands. The expectant mothers had an expected delivery date between April 2002 and January 2006. Investigators looked at the singleton children who were delivered to those women. The gestational age at birth ranged from 26.3 to 43.3 weeks. The gestational age at birth was calculated using either ultrasonographic assessment of crown-rump length (<12 weeks 5 days) or biparietal diameter (≥12 weeks 5 days) at dedicated research centers. The children then had structural neuroimaging at age 10 years. The women and their children were part of the Generation R Study, which was a longitudinal, population-based prospective birth cohort from early pregnancy onward.

There were a total of 3079 children included in the study. When they were evaluated at 10 years of age, the researchers found that gestational age at birth was linearly linked with global and regional brain volumes. They also found that longer gestational duration was linked with larger brain volumes, with every additional week of gestational duration corresponding to an additional 4.5 cm3/wk (95% CI, 2.7-6.3 cm3/wk) larger total brain volume. This link continued when the researchers limited the sample to just children born at term, gestational age at birth of 37-42 weeks, (4.8 cm3/wk; 95% CI, 1.8-7.7 cm3/wk). There was no indication of nonlinear links between gestation age and brain morphometry observed.

The investigators concluded that duration of gestation had a linear link with brain morphometry in childhood, even in the window of term delivery. They believe that their findings should be of importance, especially because of the continuing high number of elective cesarean deliveries.

Reference

1. El Marroun H, Zou R, Leeuwenburg M, et al. Association of gestational age at birth with brain morphometry. JAMA Pediatr. September 21, 2020. Epub ahead of print. doi:10.1001/jamapediatrics.2020.2991