School Performance at Ten Years in Infants ≤ 31 Weeks' Gestational Age† 1263

Abstract

The impact of prematurity on school performance was assessed in a 10 year prospective study of all 125 surviving infants ≤31 weeks' gestation born 7/1/85 to 6/30/86. Each preterm infant was matched at birth with a term infant for sex (57% male), race (86% Caucasian), and maternal age (25 ± 6 yr), education (12 ± 2 yr) and marital status (67% married). At 10 years, school performance was categorized for 120/125 preterm and 119/125 term children as either satisfactory (no grade retention, no special classroom help, normal achievement test scores in math, reading and spelling and teacher ratings of academic and intellectual functioning in the top 70% of peers) or poor (any above criteria not met). Preterm children were significantly less likely than term children to have satisfactory school performance (34% vs 61%, p<.001). Preterm children with satisfactory and poor school performance did not differ for neonatal variables including gestational age (28 ± 2 wk, both groups), severe IVH (5 vs 15%), BPD (34 vs 28%) or length of hospitalization (61 ±28 vs 67 ± 34 days). Preterm children reared in a stable family constellation (custodial make-up unchanged) and who experienced few moves were significantly more likely to have satisfactory school outcome: Table Preterm children with regular contact with both biological (or early adoptive) parents were twice as likely to have satisfactory school outcome (33/77, 43%) than were those with single parent contact (8/41, 20%; p<.01). The influence of family structure on school outcome was not significant for term children. In conclusion, while neonatal morbidities predict school outcome poorly, the family structure in which preterm children develop has a significant impact on school outcome at 10 years.