School of Public Health, The University of Adelaide, Adelaide, Australia.
School of Allied Health Sciences, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
Ultrasound Obstet Gynecol. 2021 Jul;58(1):99-104. doi: 10.1002/uog.23141.
To estimate the effect of elective induction of labor at 39 weeks' gestation on children's educational outcomes as measured using the Australian National Assessment Program-Literacy and Numeracy (NAPLAN) tests in school year 3 (∼8 years of age), compared with expectant management.
We merged perinatal data on all infants born in South Australia from 1999 to 2008 with children's school assessment data from NAPLAN. The study population included all singleton infants born without a malformation at 39-42 weeks in vertex presentation. Children who had undertaken the NAPLAN test in school year 3 were included. We excluded births to women who had a contraindication to vaginal delivery and those with a condition possibly justifying elective delivery before 39 weeks. The outcome of interest was children's educational outcome as measured using NAPLAN, which includes five learning domains (reading, writing, spelling, grammar and numeracy). Each domain was categorized according to performance at or below vs above the national minimum standard (NMS). Average treatment effects (ATEs) of elective induction of labor at 39 weeks compared with expectant management on the proportion of children performing at/below the NMS for each domain were estimated using the augmented inverse-propensity-weighted estimator, accounting for potential confounders.
Of 53 843 children born at 39-42 weeks in vertex presentation from 1999 to 2008 and who were expected to participate in the year-3 NAPLAN from 2008 to 2015, a total of 31 120 had at least one year-3 NAPLAN domain. Of these, 1353 children were delivered after elective induction of labor at 39 weeks while 29 767 children were born following expectant management. The ATEs (mean differences) of elective induction of labor at 39 weeks compared with expectant management on the proportion of children scoring at/below the NMS on each domain were 0.01 (95% CI, -0.02 to 0.03) for reading, 0.02 (95% CI, 0.00-0.04) for writing, 0.01 (95% CI, -0.01 to 0.04) for spelling, 0.02 (95% CI, -0.01 to 0.04) for grammar and 0.03 (95% CI, 0.00-0.05) for numeracy.
Elective induction of labor at 39 weeks did not affect children's standardized literacy and numeracy testing outcomes at 8 years of age when compared with expectant management. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.
通过澳大利亚国家评估计划——读写和算术能力测试（NAPLAN）评估在 39 孕周选择性引产对儿童教育结果的影响，该测试在 3 年级（约 8 岁）进行，与期待管理相比。
我们将 1999 年至 2008 年南澳大利亚所有出生婴儿的围产期数据与 NAPLAN 的儿童学校评估数据合并。研究人群包括所有在头位无畸形的单胎婴儿，在 39-42 周时出生。纳入在 3 年级接受过 NAPLAN 测试的儿童。我们排除了有阴道分娩禁忌证的产妇分娩和可能有正当理由在 39 周前进行选择性分娩的产妇分娩。感兴趣的结局是儿童的教育结果，通过 NAPLAN 测量，包括五个学习领域（阅读、写作、拼写、语法和算术）。每个领域根据在国家最低标准（NMS）以上或以下的表现进行分类。使用增强的逆倾向加权估计值估计选择性引产与期待管理相比，在每个领域中表现为 NMS 以下的儿童比例的平均治疗效果（ATE），并考虑到潜在的混杂因素。
在 1999 年至 2008 年间在 39-42 周时以头位出生并预计在 2008 年至 2015 年间参加 3 年级 NAPLAN 的 53843 名儿童中，共有 31120 名儿童至少有一个 3 年级 NAPLAN 领域。其中，1353 名儿童在 39 周时进行了选择性引产，而 29767 名儿童在期待管理下分娩。与期待管理相比，39 周时选择性引产的 ATE（平均差异）在每个领域的 NMS 以下的儿童比例分别为阅读 0.01（95%CI，-0.02 至 0.03）、写作 0.02（95%CI，0.00 至 0.04）、拼写 0.01（95%CI，-0.01 至 0.04）、语法 0.02（95%CI，-0.01 至 0.04）和算术 0.03（95%CI，0.00 至 0.05）。
与期待管理相比，选择性引产在 39 孕周不会影响 8 岁儿童的标准化读写和算术测试结果。© 2020 年国际妇产科超声学会。
