Academic Achievement Varies With Gestational Age Among Children Born at Term

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Late preterm infants are at risk for a variety of developmental impairments; however, little is known about developmental differences among children born within the term range of 37 to 41 weeks' gestation. WHAT THIS STUDY ADDS:This study links comprehensive birth record data from 128 050 term births to children' s school records 8 years later. Analyses establish that, even among the "normal term" range, gestational age is an important independent predictor of academic achievement.abstract OBJECTIVE: The goal of this study was to examine the degree to which children born within the "normal term" range of 37 to 41 weeks' gestation vary in terms of school achievement.METHODS: This study analyzed data from 128 050 singleton births born between 37 and 41 weeks' gestation in a large US city. Data were extracted from city birth records to assess a number of obstetric, social, and economic variables, at both the individual and community levels. Birth data were then matched with public school records of standardized city-wide third-grade reading and math tests. Specifically, we assessed (1) whether children born within the normal term range of 37 to 41 weeks' gestation show differences in reading and/or math ability 8 years later as a function of gestational age, and (2) the degree to which a wide range of individual-and community-level social and biological factors mediate this effect.RESULTS: Analyses revealed that gestational age within the normal term range was significantly and positively related to reading and math scores in third grade, with achievement scores for children born at 37 and 38 weeks significantly lower than those for children born at 39, 40, or 41 weeks. This effect was independent of birth weight, as well as a number of other obstetric, social, and economic factors. CONCLUSIONS:Earlier normal term birth may be a characteristic considered by researchers, clinicians, and parents to help identify children who may be at risk for poorer school performance. Pediatrics 2012;130:e257-e264 AUTHORS:

Gestational Age at Birth and Brain White Matter Development in Term-Born Infants and Children

“…Although there was no significant correlation between gestational age and intelligence quotient for the 8-year-old children (r ϭ Ϫ0.09, P ϭ .49) in our study, population-based studies have shown that white matter development is associated with cognitive functioning in 6 -10-year-old healthy children, 18 and recent large-scale studies have revealed associations between cognitive development and length of gestation in school-age children born at term. [12][13][14][15] Our results indicate that white matter changes are not likely the driving force for reported relationships between gestational age and cognitive performance in term-born children. It is noteworthy that reported white matter changes in older children/ adolescents associated with preterm birth were mostly for those born very preterm or with very low birth weight, [3][4][5]8,26 and a study of 9-year-old children with low risk preterm birth (30 -34 weeks of gestation) showed more changes in gray matter than white matter compared with term controls.…”

“…[6][7][8] The effects of gestational age on neurologic or neurodevelopment for term-born children (Ն37 completed weeks of gestation) have not been investigated until recently. Several new studies (most of them population-based) reported positive associations between longer gestational age (excluding postterm, which is Ն42 weeks of gestation) and better cognitive and/or neurodevelopment in term-born children, such as higher scores on Bayley scales of mental and motor development during the first year of life 9,10 ; more school readiness and cognitive and educational ability at age 3 years 11 ; higher intelligence quotient scores 12 and less vulnerability to low early developmental index at age 6 -7 years 13 ; greater reading, math, and achievement scores in the third grade 14 ; and better test scores in elementary and middle school and higher probability of being gifted. 15 Brain structural and functional development is directly related with neurodevelopment and cognitive performance in children.…”

Randomized Trial of Labor Induction in Women 35 Years of Age or Older

“…Some observational studies have suggested a possible association between delivery at "earlyterm" gestations (37 to 39 weeks) versus "lateterm" gestations (40 to 41 weeks) [11][12][13][14] and a subtle long-term effect on children's development and educational attainment. However, data from randomized trials to inform outcomes in infants after discharge from the hospital are lacking.…”

“…In addition, its benefits may be offset by longer-term adverse outcomes in children because of delivery at "early-term" gestation (37 to 39 weeks). [11][12][13][14] Some obstetricians in the United Kingdom already induce labor at the due date (40 weeks of gestation); rates of induction are 39% among women 40 to 44 years of age and 58% among women 45 years of age or older. Among obstetricians who do not induce labor in older pregnant women at the due date, one third are reluctant to offer induction because they are concerned about increasing the likelihood of cesarean delivery, even though they think that induction would improve perinatal outcomes.…”

Prevalence of anemia and associations between neonatal iron status, hepcidin, and maternal iron status among neonates born to pregnant adolescents

“…The definition of "term", has recently been refined to classify neonates as early (37-39 wk gestation), full (39-41 wk gestation), late (41-42 wk gestation), or post-term (≥ 42 wk gestation) (6). Early-term neonates are at higher risk of nonoptimal developmental outcomes compared to infants born at 39 wk gestational age (GA) or later (7). At this time, little is known about iron status in healthy, term neonates born to pregnant adolescents and on relative changes in iron stores that can be accrued over the last 3-5 wk of gestation.…”