New research challenges concerns over birth timing, assuring families and clinicians.
In a groundbreaking cohort study involving 155,575 births, researchers from Australia investigated the potential impact of birth at 39 weeks’ gestation on childhood educational outcomes. The study, conducted from 2005 to 2011, utilized a causal inference framework based on target trial emulation to assess numeracy and literacy scores in children aged 7 to 9.
Key Findings:
- Birth at 39 weeks’ gestation showed no association with adverse numeracy and literacy outcomes compared to birth at 40 to 42 weeks.
- The study encompassed a diverse population, with 31.8% (49,456 children) born at 39 weeks and 68.2% (106,119 children) born at 40 to 42 weeks.
- No significant differences were observed across educational domains, including grammar, numeracy, reading, spelling, and writing scores.
- Birth at 39 weeks did not increase the risk of children scoring below national minimum standards in any of the tested domains.
Reassurance Amidst Increasing Trend: The research comes at a time when birth at 39 weeks’ gestation is on the rise, influenced by the ARRIVE trial’s findings. The ARRIVE trial, a randomized clinical trial published in 2018, demonstrated benefits of induction at 39 weeks without increasing the risk of adverse perinatal outcomes.
Neurodevelopmental Considerations: Concerns had been raised about potential long-term consequences of birth at 39 weeks on neurodevelopment. Fetal brain development during the last trimester, particularly from 28 weeks onward, is characterized by rapid growth, making it a critical period. However, this study found no evidence to support adverse effects on numeracy and literacy outcomes in primary school-aged children.
Strengths and Limitations: The study’s strengths lie in its population-wide cohort, involving more than 150,000 children, and the use of a formal causal inference framework. However, limitations include the exclusion of certain risk factors and the study’s focus on a well-resourced setting, potentially limiting generalizability to less-resourced areas.
Relevance for Families and Clinicians: The findings provide reassurance to families and clinicians, suggesting that planned birth at 39 weeks’ gestation does not adversely impact children’s educational outcomes during their primary school years.
This study contributes valuable insights into the ongoing conversation about optimal gestational timing for childbirth, emphasizing the need for comprehensive understanding and consideration of long-term outcomes for both mothers and children.