{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T07:02:31Z","timestamp":1790751751113,"version":"4.1.0"},"reference-count":44,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T00:00:00Z","timestamp":1783900800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000066","name":"National Institute of Environmental Health Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000066","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Paediatric Perinatal Epid"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early and late delivery are associated with increased risk of neurodevelopmental disabilities. Some experts emphasise direct causal effect, while others propose confounding by underlying pathologies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We present detailed relative\u2010risk estimates for five major neurodevelopmental disabilities by strata of gestational age. Confounding is explored through sibling\u2010matched analyses and the relative risks of birth defects with gestational age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using data from Norway's Medical Birth Registry and other national health registries for 2.9 million births in 1967\u20132019, we conducted a prospective cohort analysis assessing gestational\u2010age\u2010specific relative risks for cerebral palsy (CP), intellectual impairment, epilepsy, autism spectrum disorder (ASD), and attention deficit\/hyperactivity disorder (ADHD). We used an analysis of sibship\u2010matched pairs to assess the role of unmeasured confounding by conditions that persist across successive pregnancies. We also compared these gestational\u2010age\u2010specific risk patterns with the corresponding risks of five birth defects present before delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Multivariable\u2010adjusted relative risks (RRs) of all five neurodevelopmental disabilities were increased with early pre\u2010term delivery. Compared with births at 40\u2009weeks, infants born at 23\u201327\u2009weeks had RRs ranging from 2\u2010fold for ADHD (RR 2.2, 95% confidence interval [CI] 2.0, 2.5) to 50\u2010fold for CP (95% CI 44, 58). Relative risks for post\u2010term delivery (\u2265\u200943\u2009weeks) were smaller, ranging from 1.15 to 1.45. In sibship analyses, relative risks with pre\u2010term delivery were attenuated, suggesting the influence of unmeasured confounding. The relative risks of birth defects with preterm and post\u2010term delivery were similar to neurodevelopmental disabilities, showing that confounding alone can produce relative risks of the magnitude seen with neurodevelopmental disabilities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The effect of gestational age at birth on neurodevelopment is likely less\u2014and perhaps much less\u2014than suggested by the observed associations. Prevention of neurodevelopmental disabilities depends not just on interventions during and after delivery, but on identifying and intervening on prenatal causes of these disabilities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ppe.70177","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T05:04:25Z","timestamp":1784005465000},"page":"794-802","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Gestational Age as a Risk Factor for Neurodevelopmental Disabilities: Exploring Causal Pathways"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3665-2006","authenticated-orcid":false,"given":"Marianna","family":"Cortese","sequence":"first","affiliation":[{"name":"Department of Nutrition Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dag","family":"Moster","sequence":"additional","affiliation":[{"name":"Department of Global Public Health and Primary Care University of Bergen  Bergen Norway"},{"name":"Department of Pediatrics Haukeland University Hospital  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rolv Terje","family":"Lie","sequence":"additional","affiliation":[{"name":"Department of Global Public Health and Primary Care University of Bergen  Bergen Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen J.","family":"Wilcox","sequence":"additional","affiliation":[{"name":"National Institute of Environmental Health Sciences  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"B.Zablotsky L. 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