Background Existing evidence is conflicting regarding perinatal risk factors independently associated with special needs in children.

Objective To identify maternal and perinatal risk factors independently associated with special needs in children.

Methods Birth records of all singleton deliveries occurring in primigravidae between 1995 and 2008 were retrieved from the Aberdeen Maternity and Neonatal Databank. They were then linked by means of Community Health Index numbers with the Support Needs System (SNS) register in Grampian. Using a case-control approach, perinatal risk factors like maternal pregnancy induced hypertension, preterm birth and low birth weight were analysed for association with the outcome whether a child required special support or not. Multiple logistic regression was used to calculate adjusted odds ratios with 95% CIs for each of the factors. Subgroup analyses were also performed using the specific diagnoses recorded in the SNS.

Results After adjusting for confounding factors, neither pre-eclampsia (Adj OR 0.80 (95% CI 0.60 to 1.07)) nor gestational hypertension (Adj OR 1.16 (95% CI 0.99 to 1.36) showed a statistically significant association with special needs. Birth before 32 weeks gestation (Adj OR 1.39 (95% CI 1.05 to 1.86)) and birth weight below 1500 g (Adj OR 2.30 (95% CI 1.17 to 4.52)) were independently associated with special needs in children.

Other factors increasing the likelihood of developing special needs include maternal age less than 20 at the time of delivery, maternal obesity, smoking and induction of labour.

Conclusions Factors associated with special needs in children include very preterm birth and very low birth weight.