Academic performance of children born preterm: a meta-analysis and meta-regression

E.S. Twilhaar, J.F. de Kieviet, C.S.H. Aarnoudse-Moens, R.M. van Elburg, J. Oosterlaan

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Background
Advances in neonatal healthcare have resulted in decreased mortality after preterm birth but have not led to parallel decreases in morbidity. Academic performance provides insight in the outcomes and specific difficulties and needs of preterm children.

Objective To study academic performance in preterm children born in the antenatal steroids and surfactant era and possible moderating effects of perinatal and demographic factors.

Design PubMed, Web of Science and PsycINFO were searched for peer-reviewed articles. Cohort studies with a full-term control group reporting standardised academic performance scores of preterm children (<37 weeks of gestation) at age 5 years or older and born in the antenatal steroids and surfactant era were included. Academic test scores and special educational needs of preterm and full-term children were analysed using random effects meta-analysis. Random effects meta-regressions were performed to explore the predictive role of perinatal and demographic factors for between-study variance in effect sizes.

Results The 17 eligible studies included 2390 preterm children and 1549 controls. Preterm children scored 0.71 SD below full-term peers on arithmetic (p<0.001), 0.44 and 0.52 SD lower on reading and spelling (p<0.001) and were 2.85 times more likely to receive special educational assistance (95% CI 2.12 to 3.84, p<0.001). Bronchopulmonary dysplasia explained 44% of the variance in academic performance (p=0.006).

Conclusion Preterm children born in the antenatal steroids and surfactant era show considerable academic difficulties. Preterm children with bronchopulmonary dysplasia are at particular risk for poor academic outcome.
Original languageEnglish
JournalArchives of Disease in Childhood-Fetal and Neonatal Edition
DOIs
Publication statusPublished - 28 Aug 2017

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Meta-Analysis
Surface-Active Agents
Bronchopulmonary Dysplasia
Steroids
Demography
Premature Birth
Reading
Cohort Studies
Morbidity
Delivery of Health Care
Pregnancy
Control Groups
Mortality

Keywords

  • Preterm birth
  • Academic performance
  • Meta-Analysis
  • Arithmetic
  • Reading
  • Spelling
  • Neonatology
  • Cognition
  • Neurodevelopment

Cite this

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title = "Academic performance of children born preterm: a meta-analysis and meta-regression",
abstract = "BackgroundAdvances in neonatal healthcare have resulted in decreased mortality after preterm birth but have not led to parallel decreases in morbidity. Academic performance provides insight in the outcomes and specific difficulties and needs of preterm children.Objective To study academic performance in preterm children born in the antenatal steroids and surfactant era and possible moderating effects of perinatal and demographic factors.Design PubMed, Web of Science and PsycINFO were searched for peer-reviewed articles. Cohort studies with a full-term control group reporting standardised academic performance scores of preterm children (<37 weeks of gestation) at age 5 years or older and born in the antenatal steroids and surfactant era were included. Academic test scores and special educational needs of preterm and full-term children were analysed using random effects meta-analysis. Random effects meta-regressions were performed to explore the predictive role of perinatal and demographic factors for between-study variance in effect sizes.Results The 17 eligible studies included 2390 preterm children and 1549 controls. Preterm children scored 0.71 SD below full-term peers on arithmetic (p<0.001), 0.44 and 0.52 SD lower on reading and spelling (p<0.001) and were 2.85 times more likely to receive special educational assistance (95{\%} CI 2.12 to 3.84, p<0.001). Bronchopulmonary dysplasia explained 44{\%} of the variance in academic performance (p=0.006).Conclusion Preterm children born in the antenatal steroids and surfactant era show considerable academic difficulties. Preterm children with bronchopulmonary dysplasia are at particular risk for poor academic outcome.",
keywords = "Preterm birth, Academic performance, Meta-Analysis, Arithmetic, Reading, Spelling, Neonatology, Cognition, Neurodevelopment",
author = "E.S. Twilhaar and {de Kieviet}, J.F. and C.S.H. Aarnoudse-Moens and {van Elburg}, R.M. and J. Oosterlaan",
year = "2017",
month = "8",
day = "28",
doi = "10.1136/archdischild-2017-312916",
language = "English",
journal = "Archives of Disease in Childhood-Fetal and Neonatal Edition",
issn = "1359-2998",
publisher = "BMJ Publishing Group",

}

Academic performance of children born preterm: a meta-analysis and meta-regression. / Twilhaar, E.S.; de Kieviet, J.F.; Aarnoudse-Moens, C.S.H.; van Elburg, R.M.; Oosterlaan, J.

In: Archives of Disease in Childhood-Fetal and Neonatal Edition, 28.08.2017.

Research output: Contribution to JournalArticleAcademicpeer-review

TY - JOUR

T1 - Academic performance of children born preterm: a meta-analysis and meta-regression

AU - Twilhaar, E.S.

AU - de Kieviet, J.F.

AU - Aarnoudse-Moens, C.S.H.

AU - van Elburg, R.M.

AU - Oosterlaan, J.

PY - 2017/8/28

Y1 - 2017/8/28

N2 - BackgroundAdvances in neonatal healthcare have resulted in decreased mortality after preterm birth but have not led to parallel decreases in morbidity. Academic performance provides insight in the outcomes and specific difficulties and needs of preterm children.Objective To study academic performance in preterm children born in the antenatal steroids and surfactant era and possible moderating effects of perinatal and demographic factors.Design PubMed, Web of Science and PsycINFO were searched for peer-reviewed articles. Cohort studies with a full-term control group reporting standardised academic performance scores of preterm children (<37 weeks of gestation) at age 5 years or older and born in the antenatal steroids and surfactant era were included. Academic test scores and special educational needs of preterm and full-term children were analysed using random effects meta-analysis. Random effects meta-regressions were performed to explore the predictive role of perinatal and demographic factors for between-study variance in effect sizes.Results The 17 eligible studies included 2390 preterm children and 1549 controls. Preterm children scored 0.71 SD below full-term peers on arithmetic (p<0.001), 0.44 and 0.52 SD lower on reading and spelling (p<0.001) and were 2.85 times more likely to receive special educational assistance (95% CI 2.12 to 3.84, p<0.001). Bronchopulmonary dysplasia explained 44% of the variance in academic performance (p=0.006).Conclusion Preterm children born in the antenatal steroids and surfactant era show considerable academic difficulties. Preterm children with bronchopulmonary dysplasia are at particular risk for poor academic outcome.

AB - BackgroundAdvances in neonatal healthcare have resulted in decreased mortality after preterm birth but have not led to parallel decreases in morbidity. Academic performance provides insight in the outcomes and specific difficulties and needs of preterm children.Objective To study academic performance in preterm children born in the antenatal steroids and surfactant era and possible moderating effects of perinatal and demographic factors.Design PubMed, Web of Science and PsycINFO were searched for peer-reviewed articles. Cohort studies with a full-term control group reporting standardised academic performance scores of preterm children (<37 weeks of gestation) at age 5 years or older and born in the antenatal steroids and surfactant era were included. Academic test scores and special educational needs of preterm and full-term children were analysed using random effects meta-analysis. Random effects meta-regressions were performed to explore the predictive role of perinatal and demographic factors for between-study variance in effect sizes.Results The 17 eligible studies included 2390 preterm children and 1549 controls. Preterm children scored 0.71 SD below full-term peers on arithmetic (p<0.001), 0.44 and 0.52 SD lower on reading and spelling (p<0.001) and were 2.85 times more likely to receive special educational assistance (95% CI 2.12 to 3.84, p<0.001). Bronchopulmonary dysplasia explained 44% of the variance in academic performance (p=0.006).Conclusion Preterm children born in the antenatal steroids and surfactant era show considerable academic difficulties. Preterm children with bronchopulmonary dysplasia are at particular risk for poor academic outcome.

KW - Preterm birth

KW - Academic performance

KW - Meta-Analysis

KW - Arithmetic

KW - Reading

KW - Spelling

KW - Neonatology

KW - Cognition

KW - Neurodevelopment

U2 - 10.1136/archdischild-2017-312916

DO - 10.1136/archdischild-2017-312916

M3 - Article

JO - Archives of Disease in Childhood-Fetal and Neonatal Edition

JF - Archives of Disease in Childhood-Fetal and Neonatal Edition

SN - 1359-2998

ER -