Gestational age at birth and child special educational needs: a UK representative birth cohort study
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Neora Alterman1, Samantha Johnson2, Claire Carson3
1National Perinatal Epidemiology Unit (NPEU), Nuffield Department of Population Health, University of Oxford, Oxford, UK neora.alterman@gmail.com.
Insights
Children born earlier, even early-term, face higher risks for special educational needs (SEN). This inverse relationship between gestational age and SEN highlights the need for early support in learning and development.
Area of Science:
- Pediatric Health
- Developmental Psychology
- Public Health
Background:
- Special Educational Needs (SEN) affect a significant portion of children.
- Gestational age at birth is a critical factor in child development.
- Understanding the full spectrum of gestational age's impact on SEN is crucial for early intervention.
Purpose of the Study:
- To investigate the association between gestational age, from preterm to full-term, and the likelihood of requiring special educational needs (SEN) in UK children at age 11.
- To quantify the risk of SEN across the entire gestational age spectrum.
Main Methods:
- Utilized data from the Millennium Cohort Study, a nationally representative UK sample.
- Collected birth and sociodemographic data at 9 months and SEN information at 11 years.
- Employed modified Poisson regression to estimate adjusted relative risks (aRRs) for SEN, controlling for confounders.
Main Results:
- 12,081 children were analyzed; 11.2% had SEN, inversely associated with gestational age.
- Infants born before 32 weeks had a 27.4% SEN prevalence, nearly three times higher than full-term births (aRR=2.89).
- Early-term births (37-38 weeks) also showed increased SEN risk (aRR=1.33), even with spontaneous labor onset.
Conclusions:
- Earlier gestational age is linked to a higher likelihood and complexity of SEN.
- The association persists even in early-term births and those with spontaneous labor.
- These findings underscore the importance of considering gestational age in identifying and supporting children with SEN.
Objective:
To examine the association between gestational age at birth across the entire gestational age spectrum and special educational needs (SENs) in UK children at 11 years of age.
Methods:
The Millennium Cohort Study is a nationally representative longitudinal sample of children born in the UK during 2000-2002. Information about the child's birth, health and sociodemographic factors was collected when children were 9 months old. Information about presence and reasons for SEN was collected from parents at age 11. Adjusted relative risks (aRRs) were estimated using modified Poisson regression, accounting for confounders.
Results:
The sample included 12 081 children with data at both time points. The overall prevalence of SEN was 11.2%, and it was inversely associated with gestational age. Among children born <32 weeks of gestation, the prevalence of SEN was 27.4%, three times higher than among those born at 40 weeks (aRR=2.89; 95% CI 2.02 to 4.13). Children born early term (37-38 weeks) were also at increased risk for SEN (aRR=1.33; 95% CI 1.11 to 1.59); this was the same when the analysis was restricted to births after labour with spontaneous onset. Birth before full term was more strongly associated with having a formal statement of SEN or SEN for multiple reasons.
Conclusion:
Children born at earlier gestational ages are more likely to experience SEN, have more complex SEN and require support in multiple facets of learning. This association was observed even among children born early-term and when labour began spontaneously.
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