Gestational Age and Basic School Achievements: A National Follow-up Study in Denmark
ABSTRACT Children born at <32 weeks' gestation are at increased risk of intellectual impairment. Few studies have focused on the majority of preterm children born at 32 to 36 weeks' gestation. We aimed to investigate the association between the full range of gestational ages at birth and the risk of not completing basic school.
This longitudinal, register-based study included all live-born infants in Denmark from 1988 to 1989. Data were obtained from national registers. School achievements were evaluated by using the examination marks. The association between gestational age and not completing basic school was estimated, taking into account the effect of their parents' educational level, being small for gestational age, plurality, and cerebral palsy.
The cohort constituted 120,585 infants, of whom 118,281 (98.6%) were alive in 2007. Of these infants, 5.01% (n = 5.928) were born before 37 weeks' gestation. Of the subjects born before 37 weeks' gestation, 11.5% (95% confidence interval: 10.7-12.4) did not complete basic school compared with 7.5% (95% confidence interval: 7.3-7.6) of those born at term. The percentage of subjects who did not complete basic school increased with decreasing gestational age. The increase was steeper at <31 weeks (4.2% per week) than at 31 to 36 weeks' gestation (0.5% per week).
The risk of not completing basic school increased with decreasing gestational age. The risk was moderate at ≥31 weeks' gestation and increased steeply at <31 weeks' gestation. The increase at <31 weeks' gestation was only partly explained by cerebral palsy.
- SourceAvailable from: Matthias Kliegel
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- "Yet, results concerning moderately to late preterm children are inconclusive . Although there is evidence that both preterm populations may differ in their risk for cognitive impairment , it remains unclear whether moderately to late premature birth is related to poorer cognitive functioning. "
ABSTRACT: Preterm birth is thought to have an adverse impact on cognitive development and self-regulation. Examining the effect of very vs. moderately to late premature birth on cognitive development and effortful control, as well as evaluating whether effortful control explains the link between preterm birth and poorer cognitive development. Fifty-eight very preterm children (<32 weeks gestation or <1500 g birth weight), 88 moderately to late preterm children (≥32 weeks gestation and ≥1500 birth weight) and 86 full-term children (≥38 weeks gestation and ≥2500 g birth weight) were examined at the corrected age of 24 months. Observational and parent-report measures of effortful control as well as the Bayley Scales of Infant Development II (BSID II, Mental Scale) as a measurement of cognitive development were analyzed. Very preterm and moderately to late preterm children showed significantly lower cognitive performance compared to full-term children. Lower effortful control scores (on observational measures, but not on parent-reports) were merely found for very preterm children compared to full-term children. Observational measures of effortful control partially mediated the effects of very preterm birth on cognitive performance, but did not explain the effects of moderately to late preterm birth on cognitive performance. Preterm birth in general is related to poorer cognitive performance in toddlerhood. In addition, effortful control mediates the effects of very preterm birth on cognitive development. Findings suggest that different mechanisms link moderately to late premature birth to poor cognitive development.Early human development 10/2011; 88(5):307-313. DOI:10.1016/j.earlhumdev.2011.09.001 · 1.93 Impact Factor
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ABSTRACT: Objective To examine how cognitive ability is related to gestational age and the extent to which observed differences could be explained by socio-economic confounding.Methods The Millennium Cohort Study collected data on 18 818 children at 9 months and 3, 5 and 7 years. Cognitive development was assessed using Bracken School Readiness Assessment at age 3, British Ability Scales II at ages 3, 5 and 7 and progress in mathematics at 7 years. Z-scores were analysed by linear regression with adjustment for confounders.ResultsChildren born at
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ABSTRACT: Preterm Birth has increased over the last decades in developed countries; the mayor contribution to this increase has been from "late preterm" births (LP). Recent publications show higher rates of mortality and morbidity for LP compared with full term infants, both in the short and long term; the risk of mortality and morbidity increases with decreasing gestational age, the lowest risk being at 39 weeks of gestation. Complications of LP birth are related to immaturity of the different organs and systems. During the neonatal period, the most frequent complications are Hyaline Membrane Disease, Transient Tachipnea, Hypoglycemia, Hyperbilirubinemia and feeding problems. In the long term, outcomes show that LP have an increased risk for developmental delay, academic and behavioral difficulties. While most complications are less frequent and less severe than extremely preterm infants, the large number of children that are born as LP represent a large population at risk. The purpose of this article is to review available evidence on mortality, morbidity and long term development in LP. This data may help obstetricians, neonatologists, pediatricians and public health workers to pay attention to this new population at risk.01/2012; 83:217-223. DOI:10.4067/S0370-41062012000300002