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Published on: November 20, 2015
Educational Performance of Children Born Prematurely
Craig F Garfield1,2,3, Krzysztof Karbownik3, Karna Murthy1,2
1Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
Insights
Children born extremely preterm showed varied educational outcomes. While many faced challenges, a notable number performed within expected norms, suggesting resilience despite early birth. Further research is needed to understand these positive outcomes.
Area of Science:
- Pediatric Health
- Educational Psychology
- Public Health
Background:
- Preterm birth survivors often experience medical issues, but their long-term educational trajectories are not fully understood.
- Gestational age at birth is a critical factor influencing child development and health outcomes.
Purpose of the Study:
- To examine the association between gestational age and educational outcomes in school-aged children.
- To assess kindergarten readiness, standardized test performance, gifted status, and low performance in relation to gestational age.
Main Methods:
- Retrospective cohort study of singleton infants born between 23 and 41 weeks' gestation in Florida (1992-2002).
- Linked birth records with public school data (1995-2012) to assess kindergarten readiness and Florida Comprehensive Achievement Test (FCAT) scores (grades 3-8).
- Outcomes included gifted status and low performance classifications.
Main Results:
- Kindergarten readiness, higher FCAT scores, and gifted status were positively associated with increased gestational age.
- Children born at 23-24 weeks' gestation performed significantly lower on FCAT tests compared to full-term infants.
- While 33.5% of low-performing students were born extremely preterm (23-24 weeks), a significant proportion of children born near the limits of viability achieved expected educational milestones.
Conclusions:
- Gestational age is a significant predictor of educational performance, with higher gestational age linked to better outcomes.
- A substantial number of children born extremely preterm demonstrate resilience and perform within expected educational norms.
- Further investigation is warranted to understand the factors contributing to successful educational attainment in preterm survivors.
Importance:
Survivors of preterm birth often present with medical morbidities; however, variation in their long-term educational performance has not been well described.
Objective:
To estimate the association between gestational age and 4 outcomes in school-aged children: readiness to enter kindergarten, scores on standardized tests in elementary and middle school, gifted status, and low performance.
Design, Setting, And Participants:
In a retrospective cohort study, children born in Florida between 1992 and 2002 at 23 to 41 weeks' gestation who entered Florida's public schools between 1995 and 2012 were assessed for kindergarten readiness and tested in mathematics and reading in grades 3 through 8. Data analysis was performed from January 12, 2016, to March 1, 2017.
Exposures:
Gestational age at birth.
Main Outcomes And Measures:
Kindergarten readiness, scores on the Florida Comprehensive Achievement Test (FCAT), classified as gifted, and classified as low performance.
Results:
A total of 1 527 113 singleton infants with gestational ages of 23 to 41 weeks born between 1992 and 2002 were matched to Florida public school records. Of these, 1 301 497 children were included in the analysis; 641 479 (49.3%) were girls. A total of 301 (65.0%) Florida children born at 23 to 24 weeks' gestation were designated as ready to start kindergarten. When the FCAT test scores were adjusted for potentially confounding maternal and infant variables, children born at 23 to 24 weeks' gestation performed 0.66 SD (95% CI, -0.73 to -0.59) lower compared with those born at full term. A total of 123 554 (9.5%) of all Florida-born public school students were considered gifted, including 17 (1.8%) of those born at 23 to 24 weeks' gestation. In comparison, 75 458 (5.8%) of all Florida-born public school students were low performing; 310 (33.5%) of these children had been born at 23 to 24 weeks' gestation. Kindergarten readiness, FCAT scores, and gifted status were positively related to gestational age, whereas low performance was inversely related to gestational age.
Conclusions And Relevance:
Although gestational age has long been associated with poor educational performance, a sufficient proportion of children born near the limits of viability performed within expected school norms, warranting further investigation into how and why certain children are able to overcome the educational burdens that may follow preterm birth.
