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Preterm birth and subsequent intelligence and academic performance in youth: A cohort study
Emilie Pi Fogtmann Sejer1, Agnes Kielgast Ladelund1, Frederik Jager Bruun1
1Department of Obstetrics and Gynecology, Herlev and Gentofte Hospital, Herlev, Denmark.
Insights
Preterm birth is linked to poorer academic outcomes and lower intelligence in youth. Children born extremely preterm had the lowest chances of graduating and lower intelligence scores.
Area of Science:
- Pediatrics
- Developmental Psychology
- Public Health
Background:
- Increasing survival rates of preterm infants globally.
- Preterm birth poses risks to long-term cognitive development.
- Need to understand the impact of preterm birth on academic and intellectual trajectories.
Purpose of the Study:
- To investigate the association between preterm birth and academic performance.
- To examine the relationship between preterm birth and intelligence in youth.
Main Methods:
- Large cohort study of liveborn children in Denmark (1978-2000).
- Used logistic and linear regressions to analyze gestational age effects.
- Adjusted for potential confounding factors.
Main Results:
- Preterm birth associated with lower academic performance and graduation rates.
- Extremely preterm infants had significantly lower odds of secondary education completion.
- Lower intelligence scores observed in preterm individuals compared to term-born peers.
Conclusions:
- Low gestational age is linked to challenges in completing secondary education.
- Preterm birth is associated with lower grade point averages and intelligence scores.
- Findings highlight the long-term impact of preterm birth on educational and cognitive outcomes.
Introduction:
Worldwide, more children than before survive preterm birth. Preterm birth can affect long-term cognitive outcomes. The aim of our study was to investigate the association between preterm birth and academic performance and intelligence in youth.
Material And Methods:
This cohort study included all liveborn children in Denmark from 1978 to 2000. We used uni- and multivariable logistic and linear regressions to analyze associations between gestational age and school graduation, grade point average (GPA), attending conscription, and male intelligence scores at conscription. We adjusted for a priori defined potential confounders.
Results:
The study included 1 450 681 children and found an association between preterm birth and lower academic performance, with children born extremely preterm having the lowest odds of graduating from lower- and upper secondary education (LSE and USE) and appearing before the conscription board (odds ratios of 0.45 [0.38-0.54], 0.52 [0.46-0.59], and 0.47 [0.39-0.56] for LSE, USE, and conscription, respectively, compared to the term group). Statistically significant differences were observed in LSE for total GPA and core subject GPA with higher GPAs in the term group, which were considered clinically relevant for mathematics with a 0.71 higher grade point for the term compared to the extremely preterm. Conversely, USE differences were less evident, and in linear regression models we found that preterm birth was associated with higher GPAs in the adjusted analyses; however, this was not statistically significant. We demonstrated statistically significant differences in intelligence scores at conscription with lower scores in the three preterm groups (-5.13, -2.73, and - 0.76, respectively) compared to the term group.
Conclusions:
Low gestational age at birth was associated with not graduating from LSE and USE, achieving lower GPAs in LSE, not attending conscription, and lower intelligence scores in young adulthood. The findings remained significant after adjusting for potential confounders.
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