School performance at age 7 years in late preterm and early term birth: a cohort study

• Published in: Archives of disease in childhood. Fetal and neonatal edition Vol. 99; no. 6; pp. F451 - F457
• Main Authors: Chan, Evelyn, Quigley, Maria A
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group 01.11.2014; BMJ Publishing Group LTD
• Subjects: Age; Archives & records; Behavior; Biological and medical sciences; Birth weight; Brain research; Cohort Studies; Delivery. Postpartum. Lactation; Developmental Disabilities - epidemiology; Developmental Disabilities - etiology; Diseases of mother, fetus and pregnancy; Educational Measurement - methods; Educational Status; England - epidemiology; Families & family life; Female; Gestational Age; Gynecology. Andrology. Obstetrics; Humans; Infant, Newborn; Infant, Premature - psychology; Longitudinal Studies; Male; Maternal, fetal and perinatal monitoring; Medical sciences; Pregnancy. Fetus. Placenta; Premature birth; Prognosis; Risk Assessment - methods; Social Class; Studies; England; United Kingdom > UK; Human; Academic achievement; Late; Pregnancy disorders; Premature delivery; Gestational age; Academic ability; School age; Newborn; Prematurity; Cohort study; Birth cohort; Early; Developmental stage; Neonatology; Neurodevelopment; preterm; Epidemiology
• ISSN: 1359-2998; 1468-2052; 1468-2052
• DOI: 10.1136/archdischild-2014-306124

Objective To investigate the effect of gestational age, particularly late preterm birth (34–36 weeks gestation) and early term birth (37–38 weeks gestation) on school performance at age 7 years. Design Population-based prospective UK Millennium Cohort Study, consisting of linked educational data on 6031 children. Methods School performance was investigated using the statutory Key Stage 1 (KS1) teacher assessments performed in the third school year in England. The primary outcome was not achieving the expected level (≥level 2) of general performance in all three key subjects (reading, writing and mathematics). Other outcomes investigated subject-specific performance and high academic performance (level 3). Results 18% of full-term children performed below the expected KS1 general level, and risk of poor performance increased with prematurity: compared to children born at full-term, there was a statistically significant increased risk of poor performance in those born very preterm (<32 weeks gestation, adjusted RR 1.78, 95% CI 1.24 to 2.54), moderately preterm (32–33 weeks gestation, adjusted RR 1.71, 95% CI 1.15 to 2.54) and late preterm (34–36 weeks gestation, adjusted RR 1.36, 95% CI 1.09 to 1.68). Early term children performed statistically significantly worse in 4 out of 5 individual subject domains than full-term children, but not in the primary outcome (adjusted RR 1.07, 95% CI 0.94 to 1.23). Conclusions Late preterm, and to a lesser extent, early term birth negatively impact on academic outcomes at 7 years as measured by KS1 assessments.