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Preterm birth, age at school entry and educational performance

David Odd1, David Evans, Alan Emond

  • 1Neonatal Unit, North Bristol NHS Trust, Bristol, United Kingdom.

Plos One
|October 23, 2013
PubMed

Insights

School entry based on actual birthday, not due date, increases learning difficulties for ex-preterm infants. This placement strategy may contribute to school failure in this vulnerable population.

Area of Science:

  • Pediatric Health
  • Developmental Pediatrics
  • Educational Psychology

Background:

  • Preterm birth is associated with an increased risk of developmental and academic challenges.
  • Current educational placement practices for preterm infants may not adequately account for their developmental trajectory.

Purpose of the Study:

  • To determine if the lack of gestational age correction in school placement contributes to school failure in ex-preterm infants.
  • To investigate the impact of school entry timing on academic outcomes for preterm children.

Main Methods:

  • A cohort study utilizing the Avon Longitudinal Study of Parents and Children (ALSPAC) dataset.
  • Comparison of academic outcomes (Key Stage 1 scores, special educational needs) between preterm (<37 weeks) and term infants.
  • Conditional regression models were employed, matching preterm infants to term infants based on date of birth, expected date of delivery, and/or school entry year.

Main Results:

  • Ex-preterm infants showed a significantly higher odds of low Key Stage 1 scores when matched by date of birth (OR 1.73) and expected date of delivery (OR 1.53).
  • This association attenuated when controlling for school entry year, suggesting its significant modifying role (p=0.029).
  • Population attributable risk for learning difficulties decreased from 4.60% to 2.12% when considering school entry year.

Conclusions:

  • School placement and assessment of ex-preterm infants based on actual birthday, rather than expected due date, may elevate their risk of learning difficulties.
  • Educational policies should consider gestational age correction for school entry to mitigate potential academic disadvantages in preterm children.
Abstract

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