Moving beyond the binary of ‘preterm’ versus ‘term’ to address the continuum of risk

The relationship between gestational age and long-term developmental outcomes has traditionally been conceptualised through a binary lens of preterm (<37 weeks’ gestation) versus term delivery. Those born preterm are then further categorised into groupings of extreme, very, moderate and late preterm birth. This categorical framework is challenged by existing research revealing gestational age as a nuanced continuum of risk, with implications for a range of neurodevelopmental outcomes throughout childhood.1 2 The recent population-based matched cohort study by de Baat et al,3 examining the effect of gestational age on special education use, replicates previous findings by MacKay et al2 in a different population and further adds weight to support a more continuous conceptualisation of preterm birth.