Objective To assess the association between gestational age classification at birth and the risk of neurodevelopmental impairments at age 3 years. Design Cohort study using the Japan Environment and Children’s Study database. Patients A total of 86 138 singleton children born without physical abnormalities at 32–41 weeks of gestation enrolled between January 2011 and March 2014. Main outcome measures Neurodevelopmental impairment, evaluated using the Ages and Stages Questionnaire (third edition). Methods Logistic regression analysis was used to evaluate the risk of neurodevelopmental impairment in moderate preterm, late preterm and early term children compared with term children after adjusting for socioeconomic and perinatal factors. Results The respective adjusted ORs (95% CIs) of incidence of scores below the cut-off value (<−2.0 SD) at age 3 years for moderate preterm, late preterm and early term births, compared with full-term births, were as follows: communication, 2.40 (1.54 to 3.73), 1.43 (1.19 to 1.72) and 1.11 (1.01 to 1.21); gross motor, 2.55 (1.69 to 3.85), 1.62 (1.36 to 1.93) and 1.20 (1.10 to 1.30); fine motor, 1.93 (1.34 to 2.78), 1.55 (1.35 to 1.77) and 1.08 (1.01 to 1.15); problem solving, 1.80 (1.22 to 2.68), 1.36 (1.19 to 1.56) and 1.07 (1.00 to 1.14) and personal-social, 2.09 (1.29 to 3.40), 1.32 (1.07 to 1.63) and 1.00 (0.91 to 1.11). Conclusion Moderate preterm, late preterm and early term births were associated with developmental impairment at age 3 years compared with full-term births, with increasing prematurity. Careful follow-up of non-full-term children by paediatricians and other healthcare providers is necessary for early detection of neurodevelopmental impairment and implementation of available intervention. The authors do not have permission to share data. Data are unsuitable for public deposition due to ethical restrictions and the legal framework of Japan. It is prohibited by the Act on the Protection of Personal Information (Act No. 57 of 30 May 2003, amendment on 9 September 2015) to publicly deposit the data containing personal information. Ethical Guidelines for Medical and Health Research Involving Human Subjects enforced by the Japan Ministry of Education, Culture, Sports, Science and Technology and the Ministry of Health, Labour and Welfare also restricts the open sharing of the epidemiological data. All inquiries about access to data should be sent to: jecs-en@nies.go.jp. The person responsible for handling enquiries sent to this email address is Dr Shoji F Nakayama, JECS Programme Office, National Institute for Environmental Studies.

中文翻译：

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中度早产、晚期早产和早产后 3 岁时的神经发育结果：日本环境与儿童研究

目的 评估出生时胎龄分类与 3 岁时神经发育障碍风险之间的关联。使用日本环境和儿童研究数据库设计队列研究。患者 2011 年 1 月至 2014 年 3 月期间，共有 86 138 名妊娠 32-41 周出生且无身体异常的单胎儿童入组。主要结果指标是神经发育障碍，使用年龄和阶段问卷（第三版）进行评估。方法在调整社会经济和围产期因素后，采用Logistic回归分析评估中度早产儿、晚期早产儿和早期足月儿与足月儿相比神经发育障碍的风险。结果 与足月出生相比，中度早产、晚期早产和早期足月出生的 3 岁时评分低于截止值 (<−2.0 SD) 的发生率各自调整后的 OR (95% CI) 如下：如下：通信，2.40（1.54至3.73）、1.43（1.19至1.72）和1.11（1.01至1.21）；粗大运动，2.55（1.69至3.85）、1.62（1.36至1.93）和1.20（1.10至1.30）；精细运动，1.93（1.34至2.78）、1.55（1.35至1.77）和1.08（1.01至1.15）；解决问题的能力为 1.80（1.22 至 2.68）、1.36（1.19 至 1.56）和 1.07（1.00 至 1.14），个人社会能力为 2.09（1.29 至 3.40）、1.32（1.07 至 1.63）和 1.00（0.91 至 1.11）。结论 与足月出生相比，中度早产、晚期早产和早期足月出生与 3 岁时发育障碍相关，且早产率增加。儿科医生和其他医疗保健提供者对非足月儿童的仔细随访对于及早发现神经发育障碍和实施可用的干预措施是必要的。作者没有共享数据的权限。由于日本的道德限制和法律框架，数据不适合公开发表。《个人信息保护法》（2003年5月30日第57号法，2015年9月9日修订）禁止公开保存包含个人信息的数据。日本文部科学省和厚生劳动省实施的涉及人类受试者的医学和健康研究伦理准则也限制了流行病学数据的公开共享。有关数据访问的所有询问均应发送至：jecs-en@nies.go.jp。负责处理发送至此电子邮件地址的查询的人员是国家环境研究所 JECS 项目办公室的 Shoji F Nakayama 博士。