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Neonatal Brain Structure, Early Life Context, and Academic Achievement among Children Born Very Preterm

Stina Oftedal1,2, Samudragupta Bora3,4, Kerstin Pannek5,6

  • 1Child Health Research Centre, Medicine and Behavioral Sciences, The University of Queensland, Centre for Children's Health Research, South Brisbane, QLD, Australia.

Journal of Pediatrics. Clinical Practice
|August 13, 2026
PubMed

Insights

Neonatal brain abnormalities and socioeconomic disadvantage independently predict poorer academic achievement in very preterm children. Brain abnormality severity did not alter the impact of disadvantage on academic outcomes.

Area of Science:

  • Neuroscience
  • Developmental Psychology
  • Pediatrics

Background:

  • Very preterm birth (<31 weeks gestation) is associated with increased risk for neurodevelopmental challenges.
  • Early life socioeconomic context can significantly influence child development and academic outcomes.
  • Understanding the interplay between biological and environmental factors is crucial for targeted interventions.

Purpose of the Study:

  • To investigate the independent association between neonatal brain abnormality severity and academic achievement at 6 years in very preterm children.
  • To determine if neonatal brain abnormality severity modifies the relationship between early life socioeconomic context and academic achievement.
  • To inform neonatal follow-up strategies by assessing both biological and socioeconomic risks.

Main Methods:

  • Prospective cohort study of 133 Australian infants born very preterm.
  • Assessment of early life socioeconomic context using a composite index at term-equivalent age.
  • Brain magnetic resonance imaging (MRI) at early and term-equivalent ages, scored using the Kidokoro criteria (Global Brain Abnormality Score).
  • Academic achievement measured at 6 years using the Woodcock-Johnson-IV Tests of Achievement (reading and mathematics).

Main Results:

  • Higher socioeconomic disadvantage was consistently linked to poorer academic achievement in reading and mathematics.
  • Greater neonatal brain abnormality severity was associated with poorer mathematics achievement (early MRI) and both reading and mathematics achievement (term-equivalent MRI).
  • No significant interaction was found between brain abnormality severity and socioeconomic disadvantage on academic outcomes.

Conclusions:

  • Neonatal brain abnormality and early life socioeconomic disadvantage are independent predictors of poorer academic achievement in very preterm children.
  • Brain abnormality severity does not modify the impact of socioeconomic disadvantage on academic achievement.
  • Neonatal follow-up should consider both biological risks (brain abnormalities) and socioeconomic factors for comprehensive assessment.
Abstract

Keywords:
Early childhoodeducational achievementmagnetic resonance imagingneurodevelopmentpreterm birth

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