Preterm Children have lower school-readiness than full-term children: JAMA

Preterm Children had a lower school readiness when compared to full-term children as per a recent study that was published in the journal JAMA Pediatrics. 

Learning challenges may be experienced by Children at school born prematurely. But there is insufficient data on the school readiness of these children as they prepare to begin grade 1. Hence, to examine the association between prematurity and school readiness in a population-based cohort of children, researchers from Canada conducted a study. 2 cohorts of children in kindergarten born between January 1, 2000, and December 31, 2011, from Manitoba, Canada were taken into the study. Prematurity was defined as gestational age less than 37 weeks and their school readiness was assessed in kindergarten using the Early Development Instrument (EDI) data. The sibling cohort comprised children born preterm, and their closest-in-age siblings' born full term. Data were analyzed between March 12 and September 28, 2021. 

The primary outcome of measurement was a vulnerability in the EDI which is defined as a score below the tenth percentile of the Canadian population norms for any 1 or more of the 5 EDI domains. The 5 EDI domains are physical health and well-being, social competence, emotional maturity, language and cognitive development, and communication skills and general knowledge. The factors associated with vulnerability in the EDI were identified by Logistic regression models. 

Results: 

• Of 86,829 eligible children, 63,277 were included, of whom 4352 were preterm with a mean gestational age of 34 weeks and 2315 boys. 58 925 were a full term with a mean GA of 39 weeks and had 29,885 boys.
• Overall, 35% of children born preterm were vulnerable in the EDI compared with 28% of children born full term.
• Compared with children born full term that born preterm had a higher percentage of vulnerability in each of the 5 EDI domains.
• In the population-based cohort, prematurity, male sex, small for gestational age, and various maternal medical and sociodemographic factors were associated with EDI vulnerability.
• In the sibling cohort, EDI outcomes were similar for both children born preterm and their sibling's born full term except for the communication skills and general knowledge domain and Multiple Challenge Index, whereas male sex and maternal age at delivery were associated with EDI vulnerability.

Thus, the researchers concluded that in a population-based cohort, children born preterm had a lower school-readiness rate than children born full term, but this difference was not observed in the sibling cohort. They also suggested that Child and maternal factors were associated with a lack of school readiness among this population-based cohort. 

For the full article, click here: 10.1001/jamapediatrics.2022.2758 

Louis D, Oberoi S, Ricci MF, et al. School Readiness Among Children Born Preterm in Manitoba, Canada [published online ahead of print, 2022 Aug 8]. JAMA Pediatr. 2022;e222758.