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Updated: Feb 24, 2026

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Academic performance of children born preterm: a meta-analysis and meta-regression

E Sabrina Twilhaar1, Jorrit F de Kieviet1, Cornelieke Sh Aarnoudse-Moens1,2

  • 1Clinical Neuropsychology Section, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|August 30, 2017
PubMed

Insights

Children born preterm face significant academic challenges, particularly in math and reading. Bronchopulmonary dysplasia increases the risk for poor academic outcomes in these vulnerable children.

Area of Science:

  • Neonatal Medicine
  • Developmental Psychology
  • Educational Psychology

Background:

  • Neonatal care advances reduce preterm mortality but not morbidity.
  • Academic performance is a key indicator of outcomes for preterm children.
  • Understanding academic difficulties is crucial for targeted interventions.

Purpose of the Study:

  • To assess academic performance in preterm children born during the antenatal steroids and surfactant era.
  • To investigate the influence of perinatal and demographic factors on academic outcomes.
  • To identify specific academic challenges faced by preterm populations.

Main Methods:

  • Systematic review and meta-analysis of peer-reviewed articles from PubMed, Web of Science, and PsycINFO.
  • Inclusion of cohort studies comparing preterm children (<37 weeks gestation) to full-term controls (≥5 years old).
  • Analysis of standardized academic scores and special educational needs, with meta-regression for moderating factors.

Main Results:

  • Preterm children scored significantly lower in arithmetic (0.71 SD), reading (0.44 SD), and spelling (0.52 SD) compared to full-term peers.
  • Preterm children were 2.85 times more likely to require special educational assistance.
  • Bronchopulmonary dysplasia accounted for 44% of the variance in academic performance.

Conclusions:

  • Preterm children born in the modern era exhibit substantial academic difficulties.
  • Bronchopulmonary dysplasia is a significant risk factor for poor academic achievement in preterm infants.
  • Early identification and support are essential for preterm children with academic challenges.
Abstract

Keywords:
neonatologyneurodevelopmentoutcomes research

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