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Gestational Age and Child Development at Age Five in a Population‐Based Cohort of Australian Aboriginal and Non‐Aboriginal Children
Author(s) -
Hanly Mark,
Falster Kathleen,
Chambers Georgina,
Lynch John,
Banks Emily,
Homaira Nusrat,
Brownell Marni,
Eades Sandra,
Jorm Louisa
Publication year - 2018
Publication title -
paediatric and perinatal epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 88
eISSN - 1365-3016
pISSN - 0269-5022
DOI - 10.1111/ppe.12426
Subject(s) - medicine , gestational age , vulnerability (computing) , demography , cohort , pediatrics , cohort study , population , social vulnerability , pregnancy , psychological intervention , environmental health , psychiatry , genetics , computer security , pathology , sociology , computer science , biology
Background Preterm birth and developmental vulnerability are more common in Australian Aboriginal compared with non‐Aboriginal children. We quantified how gestational age relates to developmental vulnerability in both populations. Methods Perinatal datasets were linked to the Australian Early Development Census (AEDC), which collects data on five domains, including physical, social, emotional, language/cognitive, and general knowledge/communication development. We quantified the risk of developmental vulnerability on ≥1 domains at age 5, according to gestational age and Aboriginality, for 97 989 children born in New South Wales, Australia, who started school in 2009 or 2012. Results Seven thousand and seventy‐nine children (7%) were Aboriginal. Compared with non‐Aboriginal children, Aboriginal children were more likely to be preterm (5% vs. 9%), and developmentally vulnerable on ≥1 domains (20% vs. 36%). Overall, the proportion of developmentally vulnerable children decreased with increasing gestational age, from 44% at ≤27 weeks to 20% at 40 weeks. Aboriginal children had higher risks than non‐Aboriginal children across the gestational age range, peaking among early term children (risk difference [RD] 19.0, 95% confidence interval [CI] 16.3, 21.7; relative risk [RR] 1.91, 95% CI 1.77, 2.06). The relation of gestational age to developmental outcomes was the same in Aboriginal and non‐Aboriginal children, and adjustment for socio‐economic disadvantage attenuated the risk differences and risk ratios across the gestational age range. Conclusions Although the relation of gestational age to developmental vulnerability was similar in Aboriginal and non‐Aboriginal children, Aboriginal children had a higher risk of developmental vulnerability at all gestational ages, which was largely accounted for by socio‐economic disadvantage.