Are prematurely born children at higher risk of lower academic performance?

Published in the open access journal JAMA Network Open, this systematic review and meta-analysis considers the associations between premature birth and academic achievement in reading and maths.

Melinda McBryde and colleagues looked at 33 unique studies comparing the academic outcomes of school-age children who were born prematurely (n=4,006) with children born full-term (n=3,317). The meta-analysis compared mean scores from standardised tests of reading and maths (and associated subskills).

The results showed that children who were born prematurely scored lower on reading comprehension and applied mathematical problems than their full-term peers. Premature children also scored lower than their term-born peers in maths calculation, decoding, mathematical knowledge, word identification and mathematical fluency.

Extremely premature children (those born at less than 28 weeks’ gestation) had significantly lower reading performance compared with children born full-term. However, children born at 28 to 32 weeks’ gestation did not exhibit later reading deficits compared with full-term peers.

Looking at the ages when assessments were carried out, in reading, prematurely born children ages 5 to 8 performed significantly worse than full-term peers, as did those ages 9 to 11. Reading deficits were significant but less pronounced when children were assessed at 12 to 18. In contrast, the magnitude of deficits in maths in prematurely born children was similar across age groups.

Source: Academic outcomes of school-aged children born preterm: A systematic review and meta-analysis (April 2020), JAMA Network Open. 2020;3(4)

Do children who are born prematurely struggle more at school?

A study published in the journal Archives of Disease in Childhood looks at whether children who are born prematurely (at 23–36 weeks) are more likely to struggle in school compared to their full-term peers.

David Odd and colleagues used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) (a longitudinal population-based cohort study that enrolled pregnant women in 1991 and 1992) to examine how the educational progress of children who are born prematurely varies from their peers throughout school, and to what extent they catch up over time.

The study found that, on average, premature children had lower test scores at Key Stage 1 (5–7 years), and continued to perform below their peers throughout school However, there was some evidence of catching up between Key Stage 1 and Key Stage 2 (age 7 to 11 years), particularly among children with the lowest scores. Between Key Stage 2 and Key Stage 4 (14-16 years) premature children progressed at a similar rate as their peers.

There was little evidence that closing the gap between KS1 and KS2 was explained by special education support. The authors point out that educating premature children in their correct school year for their expected birth date may be a cost-effective way of supporting them, and also highlight the importance of early schooling and environment for these children.Source: Prediction of school outcome after preterm birth: a cohort study (October 2018), Archives of Disease in Childhood doi: 10.1136/archdischild-2018-315441