Abstract

ObjectiveTo determine whether general cognitive ability, basic mathematic processing, and mathematic attainment are universally affected by gestation at birth, as well as whether mathematic attainment is more strongly associated with cohort-specific factors such as schooling than basic cognitive and mathematical abilities.Study designThe Bavarian Longitudinal Study (BLS, 1289 children, 27-41 weeks gestational age [GA]) was used to estimate effects of GA on IQ, basic mathematic processing, and mathematic attainment. These estimations were used to predict IQ, mathematic processing, and mathematic attainment in the EPICure Study (171 children <26 weeks GA).ResultsFor children born <34 weeks GA, each lower week decreased IQ and mathematic attainment scores by 2.34 (95% CI: −2.99, −1.70) and 2.76 (95% CI: −3.40, −2.11) points, respectively. There were no differences among children born 34-41 weeks GA. Similarly, for children born <36 weeks GA, mathematic processing scores decreased by 1.77 (95% CI: −2.20, −1.34) points with each lower GA week. The prediction function generated using BLS data accurately predicted the effect of GA on IQ and mathematic processing among EPICure children. However, these children had better attainment than predicted by BLS.ConclusionsPrematurity has adverse effects on basic mathematic processing following birth at all gestations <36 weeks and on IQ and mathematic attainment <34 weeks GA. The ability to predict IQ and mathematic processing scores from one cohort to another among children cared for in different eras and countries suggests that universal neurodevelopmental factors may explain the effects of gestation at birth. In contrast, mathematic attainment may be improved by schooling.

Highlights

  • Changes in reproduction patterns and improved neonatal medicine have led to increased numbers of moderately (32-33 weeks GA) and late preterm (34-36 weeks GA) births and increased survival rates of those born very preterm

  • We investigated the association of GA with cognitive ability (IQ), basic mathematic processing, and mathematic attainment assessed during second grade of elementary school (8 years of age) in the Bavarian Longitudinal Study (BLS) cohort born 1985/1986 in the South of Germany at 27-41 weeks GA

  • The Effect of Birth at 27-41 Weeks GA on IQ, Mathematic Processing, and Mathematic Attainment in the BLS Cohort Piecewise regressions showed that GA exerted differential effects on IQ and mathematics attainment below vs above 34 weeks and on basic mathematic processing below vs above 36 weeks

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Summary

Methods

Two prospective geographically defined birth cohorts were included, the BLS and the EPICure study. BLS Cohort The enrollment procedures have been described in detail elsewhere.[17,18,19] A total of 7505 infants (10.6% of all live births) who were born between January 1985 and March 1986 in Southern Bavaria, Germany, and required admission to a children’s hospital within the first 10 days of life were invited to participate in this study (index children). 916 term-born infants who received normal postnatal care were identified in the same hospitals.

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