preterm birth

A preterm birth can give parents reason to worry about their newborn infant’s abilities to function well in later life. One study found that many premature infants — especially those born at 23-24 weeks — face cognitive and physical limitations as they age, but that those born closer to term performed closer to expected norms.

 

A group of medical doctors and doctorate-level professionals looked to Florida for their 10-year study, running from 1992-2002. They examined the state’s single-infant preterm births during that period, stratifying gestational age at birth into two-year intervals ranging from 23-41 weeks; they then matched the birth intervals to Florida’s records showing public-school enrollment.

Further, the criteria was narrowed to include only children who remained in Florida until school age and focused on African American, Hispanic and foreign-born mothers. The refinements resulted in a 1.3 million population, evenly divided between male and female infants growing into childhood.

The births were also evaluated by maternal ethnicities, age and marital status at infant birth and educational levels, among other factors. The Journal of the American Medical Association/Pediatrics (JAMA Pediatrics) published the findings in June 2017.

A full-term pregnancy was considered one in which an infant was born from 37-42 weeks after the first day of the mother’s last menstrual cycle. The children were evaluated in four educational areas; Kindergarten readiness; Florida Comprehensive Achievement Test (FCAT) scores; gifted status, and low performance.

The children underwent the FCAT test in grades 3-8 and also were tested in math and reading. The Florida education department defined a gifted child as “one who has superior intellectual development and is capable of high performance.” As a study strength, the researchers stated the standardized FCAT and kindergarten-readiness tests provide hard numbers for the first two evaluated areas, while teachers interacting with parents, introducing subjectivity, were the ones determining whether a child was gifted or a low performer.

The doctors found that preterm infants born at 23-24 weeks showed predominantly lower levels of achievement in each of the four measured categories and in each of the nine gestational-age ranges from elementary through middle school.

But as the gestational age increased, those born closer to full-term scored higher in each category. Some even came close to levels documented among full-term children – with nearly 2% of preemies achieving gifted status.

Concluding, the researchers stated that a premature birth is not always a debilitating factor in infant/childhood development.

Among study strengths, the researchers’ work augmented existing studies showing a preterm birth is highly associated with lower childhood educational outcomes in many cases. However, with their findings, they concluded a premature birth is not always a debilitating factor in childhood development.

 

Also, they stated that their work represents the first American study linking state birth records with state education-registration data to show academic performance from kindergarten through eighth grade. In addition, they cited the length of their follow-up as a data-reinforcing measure.

As study limitations, the researchers’ work did not include data from a White infant/child population. They also indicated that affluent families may not have registered their children in Florida public schools. Further, their study included only preterm births where babies reached their first birthday.

The researchers suggested that future studies examine positive environmental factors that may cause a premature infant to overcome potentially debilitating outcomes.

 

 

Written By: Susan Mercer Hinrichs, MA, MBA, CPhT

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