Impact of Preterm Birth on Neurodevelopmental Disorders in South Korea: A Nationwide Population-Based Study.

Jong Ho Cha, Ja-Hye Ahn, Yun Jin Kim, Bong Gun Lee, Johanna Inhyang Kim, Hyun-Kyung Park, Bung-Nyun Kim, Hyun Ju Lee
Author Information
  1. Jong Ho Cha: Department of Pediatrics, Hanyang University Hospital, Hanyang University College of Medicine, Seoul 04763, Korea. ORCID
  2. Ja-Hye Ahn: Department of Pediatrics, Hanyang University Hospital, Hanyang University College of Medicine, Seoul 04763, Korea.
  3. Yun Jin Kim: Biostatistical Consulting and Research Lab, Medical Research Collaborating Center, Hanyang University, Seoul 04763, Korea. ORCID
  4. Bong Gun Lee: Department of Orthopedic Surgery, Hanyang University Hospital, Hanyang University College of Medicine, Seoul 04763, Korea.
  5. Johanna Inhyang Kim: Clinical Research Institute of Developmental Medicine, Hanyang University Hospital, Seoul 04763, Korea. ORCID
  6. Hyun-Kyung Park: Department of Pediatrics, Hanyang University Hospital, Hanyang University College of Medicine, Seoul 04763, Korea. ORCID
  7. Bung-Nyun Kim: Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul 03080, Korea. ORCID
  8. Hyun Ju Lee: Department of Pediatrics, Hanyang University Hospital, Hanyang University College of Medicine, Seoul 04763, Korea. ORCID

Abstract

Neurodevelopmental disorder (NDD) in preterm infants has become of great interest. We aimed to investigate the impact of Preterm birth on the proportion of NDD using nationwide data provided by the Korean National Health Insurance Service. We included 4894 extremely preterm or extremely low-birth-weight (EP/ELBW; <28 weeks of gestation or birth weight < 1000 g) infants, 70,583 other preterm or low-birth-weight (OP/LBW; 28−36 weeks of gestation or birth weight < 2500 g) infants, and 264,057 full-term infants born between 2008 and 2015. We observed their neurodevelopment until 6 years of age or until the year 2019, whichever occurred first. Diagnoses of NDDs were based on the World Health Organization’s International Classification of Diseases 10th revision. An association between Preterm birth and NDD was assessed using a multivariable logistic regression model. There was a stepwise increase in the risk of overall NDD with increasing degree of prematurity, from OP/LBW (adjusted odds ratio 4.46; 95% confidence interval 4.34−4.58), to EP/ELBW (16.15; 15.21−17.15). The EP/ELBW group was strongly associated with developmental delay (21.47; 20.05−22.99), cerebral palsy (88.11; 79.89−97.19), and autism spectrum disorder (11.64; 10.37−13.06). Preterm birth considerably increased the risk of NDD by the degree of prematurity.

Keywords

References

  1. J Autism Dev Disord. 2020 Dec;50(12):4504-4511 [PMID: 32347466]
  2. J Pediatr. 2018 Jun;197:75-81.e4 [PMID: 29398054]
  3. J Int Med Res. 2021 Jul;49(7):3000605211028026 [PMID: 34284680]
  4. J Neurodev Disord. 2021 Sep 21;13(1):41 [PMID: 34548007]
  5. Semin Fetal Neonatal Med. 2020 Jun;25(3):101109 [PMID: 32354556]
  6. Pediatrics. 2007 Feb;119(2):e435-43 [PMID: 17272605]
  7. JAMA. 2000 Oct 18;284(15):1939-47 [PMID: 11035890]
  8. Dev Med Child Neurol. 2000 Jul;42(7):436-47 [PMID: 10972415]
  9. Semin Fetal Neonatal Med. 2020 Jun;25(3):101114 [PMID: 32451304]
  10. Sci Rep. 2021 Jan 14;11(1):1318 [PMID: 33446672]
  11. J Pediatr. 2013 Feb;162(2):361-8 [PMID: 22947654]
  12. N Engl J Med. 2008 Jul 17;359(3):262-73 [PMID: 18635431]
  13. J Child Adolesc Psychopharmacol. 2019 Dec;29(10):764-772 [PMID: 31361509]
  14. Asia Pac Psychiatry. 2014 Dec;6(4):379-85 [PMID: 25277653]
  15. Acta Paediatr. 2011 May;100(5):691-9 [PMID: 21244484]
  16. Transl Psychiatry. 2013 Dec 03;3:e329 [PMID: 24301647]
  17. Brain. 2002 Jul;125(Pt 7):1616-23 [PMID: 12077010]
  18. BMJ. 2021 Apr 28;373:n741 [PMID: 33910920]
  19. JAMA Pediatr. 2017 Apr 3;171(4):e164805 [PMID: 28152144]
  20. Neuroimage Clin. 2021;29:102528 [PMID: 33338967]
  21. J Perinatol. 2015 Aug;35(8):660-4 [PMID: 25836321]
  22. J Pediatr. 2011 Jul;159(1):79-85 [PMID: 21349538]
  23. Pediatrics. 2011 Nov;128(5):883-91 [PMID: 22007018]
  24. Curr Opin Neurol. 2019 Aug;32(4):622-626 [PMID: 31135460]
  25. J Pediatr. 2021 Oct;237:168-176.e11 [PMID: 34171360]
  26. Dev Neurorehabil. 2012;15(3):185-90 [PMID: 22582849]
  27. Res Dev Disabil. 2013 Sep;34(9):2462-8 [PMID: 23747937]
  28. Eur Child Adolesc Psychiatry. 2021 Aug;30(8):1251-1262 [PMID: 32815033]
  29. Pediatrics. 2008 Apr;121(4):758-65 [PMID: 18381541]
  30. Pediatrics. 2011 May;127(5):858-65 [PMID: 21502231]
  31. Pediatrics. 2019 Oct;144(4): [PMID: 31558576]
  32. Pediatrics. 2017 Jun;139(6): [PMID: 28814550]
  33. BJOG. 2018 Jan;125(1):16-25 [PMID: 29024294]

Grants

  1. 2020M3E5D9080787, 2020R1F1A1048529 and 2019M3E5D1A01069345/Bio & Medical Technology Development Program of the National Research Foundation (NRF) funded by the Korean Government (MSIT)

Word Cloud

Created with Highcharts 10.0.0pretermbirthNDDdisorderinfantsEP/ELBW15NeurodevelopmentalusingnationwideHealthextremelylow-birth-weightweeksgestationweight<gOP/LBWriskdegreeprematurity4developmentaldelay11autismspectrumPretermbecomegreatinterestaimedinvestigateimpactproportiondataprovidedKoreanNationalInsuranceServiceincluded4894<2810007058328−362500264057full-termborn20082015observedneurodevelopment6yearsageyear2019whicheveroccurredfirstDiagnosesNDDsbasedWorldOrganization’sInternationalClassificationDiseases10threvisionassociationassessedmultivariablelogisticregressionmodelstepwiseincreaseoverallincreasingadjustedoddsratio4695%confidenceinterval34−4581621−17groupstronglyassociated21472005−2299cerebralpalsy887989−9719641037−1306considerablyincreasedImpactBirthDisordersSouthKorea:NationwidePopulation-BasedStudycohortneurodevelopmental

Similar Articles

Cited By