Abstract

To test whether preschool academic skills were associated with educational attainment in adolescence and whether associations differed between individuals born preterm and at full term. This prospective cohort study comprised 6,924 individuals, including N=444 (6.4%) adolescents born preterm (<37 weeks of gestation, mostly 32-36 weeks gestation) from the Avon Longitudinal Study of Parents and Children. Preschool academic (mathematics and literacy) skills were rated by teachers at 4-5 years. Educational attainment at 16 years was informed by attaining a General Certificate of Secondary Education (GCSE) in key subjects Mathematics and English. Logistic regressions assessed the association between preterm birth, preschool mathematics, and GCSE Mathematics, and between preterm birth, preschool literacy, and GCSE English. Similar numbers of adolescents born preterm and at term achieved a GCSE in Mathematics and English (53.6 % vs 57.4% and 59.5% vs 63.9, respectively; p-values>0.05). Higher preschool academic skill scores in mathematics were associated with greater odds of attaining GCSE Mathematics and preschool literacy skills were associated with GCSE English. Adolescents born preterm with higher preschool mathematics (OR 1.51, CI: 1.14, 2.00) and literacy skills (OR 1.57, CI: 1.10, 2.25) were more likely to attain GCSEs in the respective subject than their term-born counterparts with equal levels of preschool skills. Preschool academic skills in mathematics and literacy are associated with educational attainment of preterm and term-born individuals in adolescence. Children born prematurely may benefit more from preschool mathematics and literacy skills for academic and educational success into adolescence than term-born individuals.

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