General cognitive but not mathematic abilities predict very preterm and healthy term born adults’ wealth

Abstract

ObjectiveVery preterm (<32 weeks gestation; VP) and/or very low birth weight (<1500g; VLBW) children often have cognitive and mathematic difficulties. It is unknown whether VP/VLBW children’s frequent mathematic problems significantly add to the burden of negative life-course consequences over and above effects of more general cognitive deficits. Our aim was to determine whether negative consequences of VP/VLBW versus healthy term birth on adult wealth are mediated by mathematic abilities in childhood, or rather explained by more general cognitive abilities.Methods193 VP/VLBW and 217 healthy term comparison participants were studied prospectively from birth to adulthood as part of a geographically defined study in Bavaria (South Germany). Mathematic and general cognitive abilities were assessed at 8 years with standardized tests; wealth information was assessed at 26 years with a structured interview and summarized into a comprehensive index score. All scores were z-standardized.ResultsAt 8 years, VP/VLBW (n = 193, 52.3% male) had lower mathematic and general cognitive abilities than healthy term comparison children (n = 217, 47.0% male). At 26 years, VP/VLBW had accumulated significantly lower overall wealth than term born comparison adults (-0.57 (1.08) versus -0.01 (1.00), mean difference 0.56 [0.36–0.77], p < .001). Structural equation modeling confirmed that VP/VLBW birth (β = -.13, p = .022) and childhood IQ (β = .24, p < .001) both directly predicted adult wealth, but math did not (β = .05, p = .413). Analyses were controlled for small-for-gestational-age (SGA) birth, child sex, and family socioeconomic status.ConclusionThis longitudinal study from birth to adulthood shows that VP/VLBW survivors’ general cognitive rather than specific mathematic problems explain their diminished life-course success. These findings are important in order to design effective interventions at school age that reduce the burden of prematurity for those individuals who were born at highest neonatal risk.

Is Social Inequality in Cognitive Outcomes Increased by Preterm Birth–Related Complications?

“…2 They are also important predictors of later educational outcome, social status, and wealth in both very preterm and term children. 3 The findings by Benavente-Fernández et al 1 are consistent with results from a 2015 systematic review, 4 which showed that a low level of parental education is among the strongest predictors of poor overall cognitive outcomes in very preterm children. Similarly, the adverse association of moderate to severe brain injury with intelligence from childhood to adulthood has been consistently reported in longitudinal studies.…”

“…11 And still, these children are less likely to achieve the SES of their parents and show poorer outcomes on markers of wealth, such as educational level, income, and employment. 3,12 Furthermore, although there is consistent evidence that improved parenting and improved early education (often delivered together) improve long-term cognitive and academic outcomes in term children with socioeconomic disadvantage, 13 the same has not been found for those born with very low birth weight or of very low gestational age. 14 Where do we go from here?…”

Neuropsychological Outcomes at 19 Years of Age Following Extremely Preterm Birth

“…Indeed, general cognitive abilities were found to predict adult wealth in a study of very preterm and/or very low birth weight, with the very preterm and/or very low birth weight adults also having significantly lower wealth than the term-born controls. 31 Previous research by the EPICure study group has revealed that EP children are at markedly high risk of poor academic attainment 32 and that cognitive ability is a predictive factor. 33 Sixteen percent of the EP participants scored in the intellectual disability range (IQ ,70) at 19 years.…”

Frühgeburtlichkeit und langfristige Folgen bis ins Schulalter

“…Im Rahmen von einzelnen Studien wie z. B. der Bayerischen Entwicklungsstudie (BESt) (Jaekel, Baumann, et al, 2019;Jaekel, Sorg, et al, 2019) sind sehr gut dokumentierte deutsche Daten bis ins Erwachsenenalter, verfügbar. Seit 2009 existiert zudem der Forschungsverbund des German Neonatal Network (GNN) an dem mehr als 50 größere Zentren beteiligt sind (Herting et al, 2020;Humberg et al, 2020).…”