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Effect of gestational age on special education: a population-based matched cohort analysis

Tessa de Baat1, Anita C J Ravelli2,3, Cornelieke S H Aarnoudse-Moens4

  • 1Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands t.debaat@amsterdamumc.nl.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|May 12, 2025
PubMed

Insights

Children born earlier, especially extremely preterm, have a significantly higher risk of using special education. This increased risk persists even in late preterm and early-term births, highlighting the long-term impact of gestational age.

Area of Science:

  • Perinatal epidemiology
  • Developmental pediatrics
  • Special education research

Background:

  • Gestational age is a critical determinant of neonatal outcomes.
  • Understanding the long-term educational consequences of preterm birth is essential for early intervention.
  • Previous studies have indicated a link between prematurity and developmental challenges.

Purpose of the Study:

  • To investigate the association between gestational age and special education use in primary school-aged children.
  • To identify specific risk factors that exacerbate special education needs in relation to gestational age.

Main Methods:

  • A population-based matched cohort study utilizing national Dutch registries.
  • Inclusion of over 1.8 million singleton children born between 25 and 42 weeks gestation (1999-2009).
  • Linking perinatal data with mandatory special education registry data.

Main Results:

  • Overall special education prevalence was 6.6%, with rates as high as 34.7% for 25-week births versus 5.7% for 40-week births.
  • All gestational age groups showed elevated adjusted odds ratios (ORs) for special education compared to 40-week controls.
  • Risk factors like low maternal education, male sex, small for gestational age, and low Apgar scores further increased special education use.

Conclusions:

  • A strong inverse relationship exists between gestational age and special education use.
  • Increased risk for special education is evident even in late preterm and early-term/post-term births.
  • Gestational age is a crucial factor influencing long-term educational support needs.
Abstract

Keywords:
EpidemiologyNeonatology

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