Late Preterm and Early Term Birth are Associated with Poorer School Performance at Age 5 Years

Abstract

Background and aims: Some studies have observed poorer cognitive development in children born late preterm (34-36 weeks gestation) and early term (37-38 weeks gestation). Few studies have measured school performance in these children. We compared school performance in children born at full term (39-41 weeks gestation) with those born early term, late preterm and moderately/very preterm (< 34 weeks gestation). Methods: We analysed data on 7,655 children from the Millennium Cohort Study who were attending school in England in 2006. School performance was measured using the Foundation Stage Profile (FSP), a statutory assessment by teachers at the end of the child's first school year (age 5). The FSP comprises 13 assessment scales (scored from 0-9). Children who achieve an average of 6 points per scale and at least 6 in certain scales are classified as “reaching a good level of overall achievement”. Results: 51% of full term children had not reached a good level of overall achievement; this proportion increased with prematurity (55% in early term, 59% in late preterm, 64% in moderately/very preterm children). Compared with full term children, there were significantly elevated odds even in late preterm (adjusted OR 1.4, 95% CI: 1.1, 1.7) and early term (adjusted OR 1.2, 95% 1.0, 1.3) children. Early term birth accounted for a similar population attributable fraction (3%) as for all the preterm groups combined (gestation 23-36 weeks) (3%). Conclusions: Late preterm and early term birth are associated with an elevated risk of poorer school performance at age 5.