Early life antecedents of positive child health among 10- year-old children born extremely preterm

OBJECTIVE. To identify modifiable antecedents during pre-pregnancy and pregnancy windows associated with a positive child health at 10 years of age. STUDY DESIGN. Data on 889 children enrolled in the Extremely Low Gestational Age Newborn (ELGAN) study in 2002–2004 were analyzed for associations between potentially modifiable maternal antecedents during pre-pregnancy and pregnancy time windows and a previously described positive child health index (PCHI) score at 10 years of age. Stratification by race was also investigated for associations with investigated antecedents. RESULTS. Factors associated with higher PCHI (more positive health) included greater gestational age, birth weight, multiple gestation, and medical interventions, including assisted reproduction, and cervical cerclage. Factors associated with lower PCHI included correlates of lower socioeconomic status, pre-pregnancy chronic medical disorders in the mother like pre-pregnancy BMI, maternal asthma. When stratified by race, variation in significant results was observed. CONCLUSIONS. Among children born extremely preterm, medical interventions and higher SES were associated with improved PCHI while chronic illness and high BMI in the mother is associated with lower PCHI at 10 years of age. Knowledge of such antecedent factors could inform efforts to develop interventions that promote positive child health outcomes in future pregnancies.