Academic Impairment in Children Born Very Preterm at 7 and 13 Years of age

Children born very preterm (VPT) are vulnerable to academic challenges; however, it remains unclear whether these difficulties persist into early adolescence. This study aimed to investigate rates of academic impairment in children born VPT and full-term, and impairment stability from 7 to 13 years in children born VPT using 2 approaches: academic underachievement and IQ-achievement discrepancy.

Participants were children born <30 weeks' gestational age and/or <1250 g and full-term (≥37 weeks' gestational age) assessed at 7 (VPT n = 197, full-term n = 69) and 13 years (VPT n = 179, full-term n = 61) on general cognitive ability (WASI-4 and KBIT-2), word reading, spelling, and mathematics (WRAT-4).

Using an underachievement approach, children born VPT were more likely to have an academic impairment at ages 7 and 13 years compared with term-born controls, particularly in reading (odds ratio [OR] and confidence interval [CI] at 7 years: 3.72 [1.67-8.27], at 13 years: 2.55 [1.06-6.11]) and mathematics (OR [CI] at 7 years: 5.77 [2.51-13.25], at 13 years: 2.78 [1.36-5.69]). Rates of impairment were low for both groups using an IQ-achievement discrepancy approach, although a group difference was evident for mathematics impairment at 7 years (OR [CI] 5.94 [1.37-25.8]), with higher rates in the VPT group (15% vs 3%). Rates of academic impairment remained relatively stable between 7 and 13 years of age, regardless of the approach applied.

The rate of academic impairment varies depending on the approach used to classify impairment. Our findings suggest that academic difficulties in children born VPT may reflect a general cognitive impairment rather than a specific academic deficit.