Threatened Preterm Labor Is a Risk Factor for Impaired Cognitive Development in Early Childhood

Am J Obstet Gynecol. 2017 Feb;216(2):157.e1-157.e7. doi: 10.1016/j.ajog.2016.10.022. Epub 2016 Oct 22.

Abstract

Background: Threatened preterm labor is a leading cause of hospital admission during pregnancy. Patients with an episode of threatened preterm labor who deliver at term are considered to have false preterm labor. However, threatened preterm labor has been proposed as a pathologic insult that is not always sufficient to induce irreversible spontaneous preterm birth but that could alter the normal course of pregnancy.

Objective: The aim of this study was to evaluate threatened preterm labor during pregnancy as a risk factor of neurodevelopmental deficits of children at 2 years of age.

Study design: Two-year-old children who were born late preterm (n=22) or at term after threatened preterm labor (n=23) were compared with at-term control children (n=42). Neurodevelopment was evaluated at a corrected age of 24-29 months with the use of the Merrill-Palmer-Revised Scales of Development.

Results: Children who were born at term after threatened preterm labor had lower scores than control children on global cognitive index (95.4 vs 104.2; P=.011), cognition (95.1 vs 103.1; P=.021), fine motor (95.2 vs 103.4; P=.003), gross motor (84.7 vs 99.8; P=.001), memory (92.9 vs 100.4; P=.015), receptive language (93.9 vs 102.9; P=.03), speed of processing (105.7 vs 113.3; P=.011), and visual motor coordination (98.8 vs 106.7; P=.003) subtests. Children born at term after threatened preterm labor had an increased risk of mild neurodevelopmental delay compared with control children (odds ratio for global cognitive index, 2.06; 95% confidence interval, 1.09-3.88; P=.033). There were no significant differences in any cognitive domain between children who were born late preterm and children who were born at term after threatened preterm labor.

Conclusions: Threatened preterm labor is a risk factor for impaired cognitive development at 2 years of age, even if birth occurred at term.

Keywords: neurodevelopment; preterm birth; threatened preterm labor.

MeSH terms

  • Adult
  • Child Development*
  • Child, Preschool
  • Cognition*
  • Cohort Studies
  • Female
  • Humans
  • Male
  • Neurodevelopmental Disorders / epidemiology*
  • Neurodevelopmental Disorders / psychology
  • Obstetric Labor, Premature / epidemiology*
  • Pregnancy
  • Prenatal Exposure Delayed Effects / epidemiology*
  • Prenatal Exposure Delayed Effects / psychology
  • Prospective Studies
  • Term Birth*