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 neurodevel-opmental 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 al 2 in a different population and further adds weight to support a more continuous conceptualisation of preterm birth. Special education rates represent a critical public health indicator with implications for educational resource allocation, healthcare system planning and long-term economic productivity. 4 Elevated use of special education among children born preterm emphasises the significant societal impact of preterm birth. The publication