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The long-term effect of very preterm birth on school readiness: exploring preschool mediating pathways

María Francisca Morales1,2, María Inés Susperreguy3,4, Victoria Simms3,5,6

  • 1Faculty of Education, Universidad Diego Portales, Santiago, Chile. maria.moralesl@mail.udp.cl.

Pediatric Research
|August 19, 2025
PubMed

Insights

Very preterm birth is linked to lower math skills in children, mediated by early executive function and vocabulary deficits. Early interventions targeting these skills can improve school readiness for this vulnerable group.

Area of Science:

  • Developmental Psychology
  • Pediatrics
  • Cognitive Neuroscience

Background:

  • Very preterm children often experience developmental challenges in school.
  • Mechanisms linking preterm birth to later difficulties are not fully understood.
  • This study investigates early predictors of school-age outcomes in very preterm children.

Purpose of the Study:

  • To examine the association between very preterm birth and children's math skills, behavioral, and emotional difficulties.
  • To investigate the mediating role of executive functions and receptive vocabulary during preschool years.
  • To identify early cognitive mechanisms influencing long-term academic challenges for very preterm children.

Main Methods:

  • Utilized data from the 'Encuesta Longitudinal de la Primera Infancia' Chilean cohort (10,098 children, 147 very preterm).
  • Assessed very preterm status and sociodemographics at ages 1-3.
  • Measured executive functions and receptive vocabulary at ages 3-6, and math skills, behavioral, and emotional difficulties at ages 8-12.

Main Results:

  • Very preterm children demonstrated significantly lower math skills compared to term-born peers.
  • Reduced executive functions and receptive vocabulary partially mediated this association.
  • No direct link was found between very preterm birth and behavioral/emotional difficulties, but indirect effects via general cognitive abilities were observed.

Conclusions:

  • Very preterm birth has long-term effects on school readiness, particularly math skills.
  • Early interventions focusing on executive functions and receptive vocabulary in preschool can mitigate adverse outcomes.
  • Findings underscore the importance of early cognitive support for very preterm children's academic success.
Abstract

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