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Very preterm children free of disability or delay at age 2: predictors of schooling at age 8: a population-based
M L Charkaluk1, P Truffert, L Marchand-Martin
1INSERM, UMR S 953, IFR 69, Research Unit on Perinatal Health and Women's and Children's Health, F-75020, Paris, France; Groupe Hospitalier de l'Institut Catholique Lillois / Faculté Libre de Médecine, F-59000 Lille, France; UPMC Univ Paris 06, UMR S 953, F-75005, Paris, France.
Aim:
To study the predictive value of a developmental assessment at 2 years corrected age (CA) for schooling at age 8 in children born very preterm and free of disability or delay; to identify other factors associated with schooling in this population.
Methods:
244 children born before 33 weeks in 1997, part of the population-based EPIPAGE cohort study, free of disability or delay, had their developmental quotient (DQ) evaluated with the Brunet-Lezine scale at 2 years CA. The mental processing composite (MPC) score was evaluated at age 5 with the K-ABC battery. Data on schooling were obtained at age 8 by postal questionnaire. Schooling was considered appropriate if the child was attending age-appropriate grade level in a regular classroom environment without support at school.
Results:
Schooling was appropriate for 172 (70%) children. The predictive value of a DQ≥100 for appropriate schooling was 0.80 [0.75;0.85]. In children with a DQ at age 2<100, schooling varied significantly according to their MPC score at age 5 whereas it didn't in children with a DQ≥100. In multivariate analysis, the rate of appropriate schooling was significantly related to global DQ at age 2 (p<0.01), gestational age≥29 weeks (p<0.05), head circumference at age 2 (p<0.05) and mother's educational level (p<0.05).
Conclusion:
A DQ≥100 cannot be solely used for the prediction of appropriate schooling at age 8. Mother's educational level, gestational age and head circumference at age 2 could be taken account. These factors could be used to individualise follow-up.
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