Preterm Birth, Age at School Entry and Long Term Educational Achievement

Area of Science:

• Pediatrics
• Developmental Psychology
• Educational Psychology

Background:

• Preterm infants (<37 weeks gestation) often start school based on their due date, not birth date.
• This can lead to them starting a year earlier than their term-born peers.
• Initial academic struggles in early childhood for these infants are documented, but long-term effects are unclear.

Purpose of the Study:

• To determine if the educational disadvantages experienced by preterm infants persist into adolescence.
• To investigate the impact of early school entry on the long-term academic achievement of preterm infants.

Main Methods:

• A cohort study using data from the Avon Longitudinal Study of Parents and Children (ALSPAC).
• Exposure: Gestational age (preterm vs. term).
• Outcomes: Key Stage 4 (KS4) scores and special educational needs (SEN) support at age 16.
• Statistical analysis involved conditional regression models with matching on date of birth (DOB), expected date of delivery (EDD), or both, and school entry year.

Main Results:

• Preterm infants had higher odds of requiring SEN support (OR 1.39, 95% CI 1.14-1.68) after matching for DOB and adjusting for confounders.
• This association persisted when matching for EDD (aOR 1.43, 95% CI 1.17-1.74).
• The link between prematurity and SEN support attenuated when controlling for school entry year (aOR 1.21, 95% CI 0.97-1.52), with no significant impact on KS4 scores.

Conclusions:

• Entering school a year earlier than predicted by their due date has measurable negative consequences for ex-preterm infants in adolescence.
• This modifiable factor, related to school entry timing, may limit future opportunities for preterm individuals.
• Addressing school entry policies for preterm infants could improve long-term educational outcomes.