Reassuring news on safety of elective birth at 39 weeks’ gestation

By Melanie Hinze
Elective birth at 39 weeks’ gestation is not associated with developmental vulnerability in childhood, according to new Australian research, published in JAMA Pediatrics.

Although induction of labour at 39 weeks has been shown previously to result in fewer caesareans and a lower risk of stillbirth, the authors of this new study aimed to assess the longer-term developmental outcomes for children at school entry.

The cohort study used Australian, statewide, population-based perinatal data, and included 88,165 births between January 2005 and December 2013. These data were linked to childhood developmental outcomes at age 4 to 6 years (measured via the Australian Early Development Census).

The study authors defined childhood developmental vulnerability at school entry as scoring below the 10th percentile in at least two of the following five developmental domains assessed: physical health and wellbeing, social competence, emotional maturity, school-based language and cognitive skills, and communication skills and general knowledge.

When compared with expectant management, in which birth occurred between 40- and 43-weeks’ gestation, elective birth at 39 weeks was not associated with an altered risk of childhood global developmental vulnerability, or with developmental vulnerability in any individual domains.

Additionally, when compared with planned caesarean at 39 weeks, induction of labour at 39 weeks’ gestation was shown to have a comparable risk of childhood developmental vulnerability and vulnerability in any individual domain.

Among the coauthors were Dr Anthea Lindquist, Obstetrician, and Dr Roxanne Hastie, Perinatal Epidemiologist, at the Mercy Hospital for Women, Melbourne.

‘Our findings provide some much-needed reassurance for parents and clinicians about the safety of elective birth at 39 weeks,’ said Dr Lindquist, who is also Senior Research Fellow in Perinatal Epidemiology at the University of Melbourne.

‘Our study didn’t examine outcomes for babies born at 37 and 38 weeks, and we know that there are lots of developmental benefits gained during those additional few weeks of gestation,’ she said. ‘However, there is a great deal of evidence suggesting that birth at 39 weeks is safe for mums and babies, we’ve now also shown that it does not lead to any longer-term harm for children,’ she added.
JAMA Pediatr 2022; doi: 10.1001/jamapediatrics.2022.1165.