Babies Born At 37 To 39 Weeks Have Higher Risk Of Autism And Special Educational Needs
Editor's ChoiceMain Category: Pediatrics / Children's Health
Also Included In: Pregnancy / Obstetrics; Autism; Dyslexia
Article Date: 09 Jun 2010 - 10:00 PDT
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After analyzing the birth history of over 400,000 schoolchildren, Scottish researchers found that the risk of autism and/or special educational needs (SEN) were 1.16 times greater for babies born at 37 to 39 weeks of gestation, compared to those born at the full 40 weeks. This finding has important implications for the timing of elective Cesarean deliveries.
Children with SEN (special educational needs) may have either:
- A learning difficulty, such as dyslexia or autism that requires special educational help.
- A physical difficulty, such as poor vision or deafness that requires special educational help.
However, the risks of SEN later in life for babies born across a whole range of gestation (from 24-40 weeks) had not previously been investigated.
Pell and team's study showed that compared to babies born at 40 weeks, those born at 37-39 weeks of gestation were 1.16 times as likely to have an SEN. Although the risk of SEN was much higher in preterm than in early term babies, because many more children were born between 37 and 39 weeks (about a third of babies) than before 37 weeks (one in 20 babies), early term births accounted for 5.5% of cases of SEN whereas preterm deliveries accounted for only 3.6% of cases.
The researchers explained that the these results demonstrate that even a baby born at 39 weeks has a higher risk of SEN, compared to babies born a week later. The normal timing for elective deliveries (e.g. cesarean section) is 39 weeks.
"Gestational Age at Delivery and Special Educational Need: Retrospective Cohort Study of 407,503 Schoolchildren."
MacKay DF, Smith GCS, Dobbie R, Pell JP (2010)
PLoS Med 7(6): e1000289
doi:10.1371/journal.pmed.1000289
Written by Christian Nordqvist
Copyright: Medical News Today
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Visitor Opinions In Chronological Order (2)
37-39 Weeks Is A Standard For Most Babies Anyway!
posted by Vince Steele on 10 Jun 2010 at 2:48 amApart from the fact that I have 3 sons on the Autism Spectrum, who all went over 40 weeks, I would have thought 37 to 39 weeks a standard for most babies anyway, regardless of their neurological makeup. I imagine there would be a great deal more babies born without Autism at this point of pregnancy than babies with Autism.
It's a bit like saying there's a greater risk of having blue eyes at age 37 to 39 weeks.... that's because most babies are born in that window of time. 37 to 39 weeks is actually a week longer than 40 to 41 weeks, so the maths is also flawed for statistical purposes. Sorry, I don't buy this one.
Difference Is Actually Negligible
posted by Pauline McDonagh (Hull) on 12 Jun 2010 at 8:09 amThe presentation of the results of this research is very misleading, particularly in relation to the risks associated with cesarean delivery at 39 weeks' gestation.
This is the actual percentage of children with SEN by gestation of delivery
37 weeks - 6.1%
38 weeks - 5.4%
39 weeks - 4.7%
40 weeks - 4.4%
41 weeks - 4.1%
As you can see, the difference between 39 and 40 weeks is negligible; the higher risk is present in the 37th and 38th week, which we know from other research increases other risks for babies too, such as respiratory distress.
The collective risk of all babies at 37-39 weeks is being used to disparage the legitimacy of choosing to deliver your baby at or after 39 weeks (many doctors, my own included, advise delivery at 39 and a half weeks with maternal request - i.e. during the 40th week).
Three final points worthy of note:
The authors state that while it's reported that early term births (at 37-39 weeks) account for 5.5% of SEN cases and preterm deliveries account for 3.6% of cases, this is because of the higher numbers of babies born between 37 and 39 weeks.
In the population of children studied (407,503), just 16.2% were born by cesarean delivery; therefore I would argue that the risk of SEN is just as likely, if not more, with a planned vaginal delivery (where Mother Nature decides on the gestational age or delivery is induced)as a planned cesarean at or after 39 weeks.
The relatively small percentage of cesareans includes both planned and emergency surgeries, thereby further reducing the data pool of the very delivery type that such stark warnings are being given in reports like this one.
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