Kerstjens, J.M., et al. of the Beatrix Children’s Hospital in Groningen, The Netherlands conducted a large study looking into the maternal and pregnancy-related factors that contribute to developmental delay in moderately preterm children. The purpose of this research was to explore and document whether certain maternal and pregnancy factors had a later effect causing developmental and behavioral problems in the newborn children, followed by social disabilities in adulthood. The research is important because of the relative increase in prematurity in recent years and the social and economic implications of these disabilities. By learning about this subject, physicians may be able to enhance pre-natal care to account for those factors that may lead to the eventual impairments discussed. The hypothesis was that certain factors increase the risk of preterm birth, neonatal morbidity, and neonatal morbidity, and perhaps these same factors increase the risk of developmental delay in childhood too. The expectation was for certain factors to be linked with developmental delays, such as small for gestational age, prepregnancy maternal obesity, and male sex, as these were all previously shown to have a consequence on infant development,
The study was a longitudinal, community based cohort study in Holland. After exploring a large number of people, eventually 960 moderately preterm babies were recruited for the study. Parents of the children were asked to fill out the Ages and Stages questionnaire, which attempts to measure five different domains of development. A score of two standard deviations below the normal was evidence of a developmentally delayed child. Data on the mothers was collected and eventually the researchers settled on four categories of maternal and pregnancy-related factors: maternal preexisting, maternal pregnancy related, fetal, and delivery factors. Sociographic and lifestyle variables were studied and eventually the questionnaire was cross-referenced with maternal doctors visits to get. And the authors proceeded to draw correlations from the questionnaires and the four categories that they had described.
The results confirmed a link between SGA and developmental delay throughout the stages of development. The authors conjecture that children born SGA suffer from a nutritional or oxygen deficit. It was confirmed that prepregnancy obesity carries a negative influence on preterm birth and developmental progress later on. Multi-pregnancy and giving birth to twins also seems to cause poorer developmental outcomes and the authors link this to interuterine growth retardation. The final factor strongly associated with developmental delay was male sex. No links were found between maternal pregnancy related factors or delivery related factors and developmental delay. In fact it could be said that only fetal factors seem to be responsible for developmental delay.
The results showed the researchers how important it is to avoid premature brirths if at all possible. SGA, maternal prepregnancy obesity, being one of a multiple, and male sex all seem to contribute to developmental delay. This paper’s impact on me is large because given the increase in preterm babies, we should begin to expect to see many more developmental delays in the future.
In conclusion, it is a narrow set of factors that potentially cause prematurity and possible developmental growth delay, however the effects of such pathology are so profound, that it is in our best interests to try and prevent or control them.
Kerstjens, J.M., et al (2013). Maternal and Pregnancy-Related factors associated with developmental daily in moderately Preterm-Born Children. Obstetrics and Gynecology. 121(4) 727 -732.