Searle Amelia K, Smithers Lisa G, Chittleborough Catherine R, Gregory Tess A, Lynch John W
School of Public Health, University of Adelaide, Adelaide, South Australia, Australia.
School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.
Arch Dis Child Fetal Neonatal Ed. 2017 Sep;102(5):F409-F416. doi: 10.1136/archdischild-2016-310950. Epub 2017 Feb 2.
Academic achievement varies according to gestational age but it is unclear whether achievement varies within 'term' (37-41 weeks gestation) or for 'post-term' births (≥42 weeks). We examined gestational age from preterm to post-term against a national minimum standard for academic achievement in population data.
Literacy and numeracy data of 8-year-old South Australian grade 3 children in 2008-2010 were linked to routinely collected perinatal data (N=28 155).
Longer gestation from 23 to 45 weeks was associated with lower risk of poor literacy and numeracy. Adjusted relative risks for being at or below national minimum standard ranged from 1.12 (95% CI 1.03 to 1.22) for 'late preterm' (32-36 weeks) for numeracy, to 1.84 (95% CI 1.48 to 2.30) for 'early preterm' (23-31 weeks) for writing. Within term, every additional week of gestational age was associated with small decreased risks of poor literacy and numeracy (eg, relative risks for poor numeracy 1.10, 95% CI 1.01 to 1.20 for 37 weeks). Population-attributable fractions for poor achievement were highest among children born 'early term' (37-39 weeks) due to their higher population prevalence.
Shorter gestational age was associated with increased risk of poor literacy/numeracy. While children born 'early term' experience only between 1% and 10% increased risk, they constitute a larger proportion of children with poor educational achievement than preterm children, and thus are important to consider for supportive interventions to improve population-level achievement gains. The seemingly lower risk for post-term children showed large error estimates and warrants further consideration within even larger populations.
学业成绩因胎龄而异，但尚不清楚在“足月”（妊娠37 - 41周）内或“过期产”（≥42周）时成绩是否有所不同。我们在人口数据中，对照国家学业成绩最低标准，研究了从早产到过期产的胎龄情况。
将2008 - 2010年南澳大利亚州三年级8岁儿童的读写和算术数据与常规收集的围产期数据相联系（N = 28155）。
妊娠23至45周时间越长，读写和算术能力差的风险越低。处于或低于国家最低标准的调整后相对风险范围从算术方面“晚期早产”（32 - 36周）的1.12（95%可信区间1.03至1.22）到写作方面“早期早产”（23 - 31周）的1.84（95%可信区间1.48至2.30）。在足月范围内，胎龄每增加一周，读写和算术能力差的风险就有小幅降低（例如，37周时算术能力差的相对风险为1.10，95%可信区间1.01至1.20）。由于“早期足月”（37 - 39周）出生儿童的人群患病率较高，因此学业成绩差的人群归因分数在这些儿童中最高。
胎龄较短与读写/算术能力差的风险增加有关。虽然“早期足月”出生的儿童风险仅增加1%至10%，但他们在学业成绩差的儿童中所占比例比早产儿童更大，因此对于改善人群水平的学业成绩增益的支持性干预措施而言，考虑他们很重要。过期产儿童看似较低的风险显示出较大的误差估计，需要在更大规模人群中进一步研究。
