Profiles of developmental disorder and associations with gestational age

Katherine Jane Pettinger; Sarah Louise Blower; Elaine M Boyle; Catherine Elizabeth Hewitt; Lorna K Fraser

doi:10.1136/archdischild-2024-327962

Profiles of developmental disorder and associations with gestational age

Katherine Jane Pettinger, Sarah Louise Blower, Elaine M Boyle, Catherine Elizabeth Hewitt, Lorna K Fraser

Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation

Research output: Contribution to journal › Article › peer-review

Abstract

Objective This study aimed to examine profiles of co-occurrence of developmental disorders and their association with birth before full term. Design Latent class analysis of cohort data with linked health data. Setting Bradford, England. Patients 13 172 children were included in the analysis. Outcome measures Developmental disorder in medical records. Methods Data were censored at each child's 12th birthday. The latent class analysis identified patterns of developmental disorders. Multinomial logistic regression explored the association with gestational age while adjusting for clinical and socio-factors. Results The majority (12,536) had a low risk of developmental disorders; this group was named 'typical development'. The remaining children were classified into three groups: 'educational difficulties' (347 children); 'social, emotional, behavioural and communication difficulties' (189 children) and 'early developmental impairment, with physical and intellectual disabilities' (100 children). Compared with 'typical development', very preterm birth was associated with an increased likelihood of being in the 'early developmental impairment, with physical and intellectual disabilities' group, adjusted relative risk ratio (aRRR): 9.22 (95% CI 4.58 to 18.55). Birth before full term was associated with increased likelihood of being in the 'educational difficulties' group; risk was highest <34 weeks (aRRR: 2.64 (95% CI 1.44 to 4.83)) but persisted up to 37-38 weeks: aRRR: 1.41 (95% CI 1.10 to 1.81). There was no association between gestational age and the 'social, emotional, behavioural and communication difficulties'' group. Conclusion Four distinct profiles of developmental disorders were identified; gestational age was associated with two of these. Understanding which disorders children are most at risk of and how these co-occur can help provide accurate information to families and contribute to prompt diagnosis.

Original language	English
Article number	327962
Journal	Archives of Disease in Childhood
DOIs	https://doi.org/10.1136/archdischild-2024-327962
Publication status	E-pub ahead of print - 10 Feb 2025

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@article{6512a5a0ddf74c1999c707c63c5ab644,

title = "Profiles of developmental disorder and associations with gestational age",

abstract = "Objective This study aimed to examine profiles of co-occurrence of developmental disorders and their association with birth before full term. Design Latent class analysis of cohort data with linked health data. Setting Bradford, England. Patients 13 172 children were included in the analysis. Outcome measures Developmental disorder in medical records. Methods Data were censored at each child's 12th birthday. The latent class analysis identified patterns of developmental disorders. Multinomial logistic regression explored the association with gestational age while adjusting for clinical and socio-factors. Results The majority (12,536) had a low risk of developmental disorders; this group was named 'typical development'. The remaining children were classified into three groups: 'educational difficulties' (347 children); 'social, emotional, behavioural and communication difficulties' (189 children) and 'early developmental impairment, with physical and intellectual disabilities' (100 children). Compared with 'typical development', very preterm birth was associated with an increased likelihood of being in the 'early developmental impairment, with physical and intellectual disabilities' group, adjusted relative risk ratio (aRRR): 9.22 (95% CI 4.58 to 18.55). Birth before full term was associated with increased likelihood of being in the 'educational difficulties' group; risk was highest <34 weeks (aRRR: 2.64 (95% CI 1.44 to 4.83)) but persisted up to 37-38 weeks: aRRR: 1.41 (95% CI 1.10 to 1.81). There was no association between gestational age and the 'social, emotional, behavioural and communication difficulties'' group. Conclusion Four distinct profiles of developmental disorders were identified; gestational age was associated with two of these. Understanding which disorders children are most at risk of and how these co-occur can help provide accurate information to families and contribute to prompt diagnosis.",

author = "Pettinger, {Katherine Jane} and Blower, {Sarah Louise} and Boyle, {Elaine M} and Hewitt, {Catherine Elizabeth} and Fraser, {Lorna K}",

note = "{\textcopyright} Author(s) (or their employer(s)) 2025. Re-use permitted under CC BY. Published by BMJ Group.",

year = "2025",

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doi = "10.1136/archdischild-2024-327962",

language = "English",

journal = "Archives of Disease in Childhood",

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T1 - Profiles of developmental disorder and associations with gestational age

AU - Pettinger, Katherine Jane

AU - Blower, Sarah Louise

AU - Boyle, Elaine M

AU - Hewitt, Catherine Elizabeth

AU - Fraser, Lorna K

PY - 2025/2/10

Y1 - 2025/2/10

N2 - Objective This study aimed to examine profiles of co-occurrence of developmental disorders and their association with birth before full term. Design Latent class analysis of cohort data with linked health data. Setting Bradford, England. Patients 13 172 children were included in the analysis. Outcome measures Developmental disorder in medical records. Methods Data were censored at each child's 12th birthday. The latent class analysis identified patterns of developmental disorders. Multinomial logistic regression explored the association with gestational age while adjusting for clinical and socio-factors. Results The majority (12,536) had a low risk of developmental disorders; this group was named 'typical development'. The remaining children were classified into three groups: 'educational difficulties' (347 children); 'social, emotional, behavioural and communication difficulties' (189 children) and 'early developmental impairment, with physical and intellectual disabilities' (100 children). Compared with 'typical development', very preterm birth was associated with an increased likelihood of being in the 'early developmental impairment, with physical and intellectual disabilities' group, adjusted relative risk ratio (aRRR): 9.22 (95% CI 4.58 to 18.55). Birth before full term was associated with increased likelihood of being in the 'educational difficulties' group; risk was highest <34 weeks (aRRR: 2.64 (95% CI 1.44 to 4.83)) but persisted up to 37-38 weeks: aRRR: 1.41 (95% CI 1.10 to 1.81). There was no association between gestational age and the 'social, emotional, behavioural and communication difficulties'' group. Conclusion Four distinct profiles of developmental disorders were identified; gestational age was associated with two of these. Understanding which disorders children are most at risk of and how these co-occur can help provide accurate information to families and contribute to prompt diagnosis.

AB - Objective This study aimed to examine profiles of co-occurrence of developmental disorders and their association with birth before full term. Design Latent class analysis of cohort data with linked health data. Setting Bradford, England. Patients 13 172 children were included in the analysis. Outcome measures Developmental disorder in medical records. Methods Data were censored at each child's 12th birthday. The latent class analysis identified patterns of developmental disorders. Multinomial logistic regression explored the association with gestational age while adjusting for clinical and socio-factors. Results The majority (12,536) had a low risk of developmental disorders; this group was named 'typical development'. The remaining children were classified into three groups: 'educational difficulties' (347 children); 'social, emotional, behavioural and communication difficulties' (189 children) and 'early developmental impairment, with physical and intellectual disabilities' (100 children). Compared with 'typical development', very preterm birth was associated with an increased likelihood of being in the 'early developmental impairment, with physical and intellectual disabilities' group, adjusted relative risk ratio (aRRR): 9.22 (95% CI 4.58 to 18.55). Birth before full term was associated with increased likelihood of being in the 'educational difficulties' group; risk was highest <34 weeks (aRRR: 2.64 (95% CI 1.44 to 4.83)) but persisted up to 37-38 weeks: aRRR: 1.41 (95% CI 1.10 to 1.81). There was no association between gestational age and the 'social, emotional, behavioural and communication difficulties'' group. Conclusion Four distinct profiles of developmental disorders were identified; gestational age was associated with two of these. Understanding which disorders children are most at risk of and how these co-occur can help provide accurate information to families and contribute to prompt diagnosis.

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U2 - 10.1136/archdischild-2024-327962

DO - 10.1136/archdischild-2024-327962

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C2 - 39929706

SN - 0003-9888

JO - Archives of Disease in Childhood

JF - Archives of Disease in Childhood

M1 - 327962

ER -

Profiles of developmental disorder and associations with gestational age

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