PC1090: Academic Outcomes in Moderate and Late Preterm Infants: Are They Catching Up?

Background: One in ten babies in the United States is born preterm ( < 37 completed weeks of gestation). Of preterm infants, 85% are born between 32 and 36 completed weeks of gestation, classifying them as moderate to late preterm. Premature babies have challenges with development as compared to term infants, and their outcomes are impacted by factors including socioeconomic level and gender. Despite the preventive efforts created in neonatal intensive care units for preterm babies, studies have shown that preterm infants continue to have learning difficulties and decreased school performance.

Methods: Using the Early Childhood Longitudinal Study (ECLS) Kindergarten class of 2011 cohort database sponsored by the National Center for Education Statistics within the U.S. Department of Education, we identified 14,350 full term infants and 1,195 moderate and late preterm infants to include for analysis of their academic scores in reading, math, and science. Students were tested each year through direct cognitive assessments created by the study. All parents filled out surveys for demographic data. All data analysis was done using SAS version 9.4. Data were weighted to be representative of the U.S. population. We assessed relationships between gestational age and academic outcomes using regression analysis and least squares means. Confounders were analyzed through regression analysis.

Results: Children born late preterm between 35 and 36 6/7 weeks gestation had no significant difference in their academic scores in reading, math, and science at any grade level when compared to term children. Children who were moderate preterm (32 to 34 6/7 weeks gestation) had significantly lower scores in reading and math that improved by first grade when compared to term children. Science scores had no significant difference between all gestations at any grade. This pattern continues when adjusting for confounders including gender, race, household income level, school type, and home setting, except in math where moderate preterm children have significantly lower scores in second and fourth grade.

Conclusion: These data align with previous studies that prematurity is a risk factor for long-term academic complications, but the infants born after 35 weeks gestation appear to do just as well as term infants in this recent cohort of children sampled from across the United States. Infants who are born moderately preterm have more difficulty in school based on their lower academic scores, but they are able to catch up by first grade and have similar academic scores as their peers. While prematurity affects school outcomes, our data found that when adjusting for household income, gender, race, school type, and home setting, there was significant impact on outcomes in math in later grades. Moderate and late preterm infants are able to catch up to term infants throughout schooling, but socioeconomic factors affect their outcomes as well.