Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois.
Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
JAMA Pediatr. 2017 Aug 1;171(8):764-770. doi: 10.1001/jamapediatrics.2017.1020.
Survivors of preterm birth often present with medical morbidities; however, variation in their long-term educational performance has not been well described.
To estimate the association between gestational age and 4 outcomes in school-aged children: readiness to enter kindergarten, scores on standardized tests in elementary and middle school, gifted status, and low performance.
DESIGN, SETTING, AND PARTICIPANTS: In a retrospective cohort study, children born in Florida between 1992 and 2002 at 23 to 41 weeks' gestation who entered Florida's public schools between 1995 and 2012 were assessed for kindergarten readiness and tested in mathematics and reading in grades 3 through 8. Data analysis was performed from January 12, 2016, to March 1, 2017.
Gestational age at birth.
Kindergarten readiness, scores on the Florida Comprehensive Achievement Test (FCAT), classified as gifted, and classified as low performance.
A total of 1 527 113 singleton infants with gestational ages of 23 to 41 weeks born between 1992 and 2002 were matched to Florida public school records. Of these, 1 301 497 children were included in the analysis; 641 479 (49.3%) were girls. A total of 301 (65.0%) Florida children born at 23 to 24 weeks' gestation were designated as ready to start kindergarten. When the FCAT test scores were adjusted for potentially confounding maternal and infant variables, children born at 23 to 24 weeks' gestation performed 0.66 SD (95% CI, -0.73 to -0.59) lower compared with those born at full term. A total of 123 554 (9.5%) of all Florida-born public school students were considered gifted, including 17 (1.8%) of those born at 23 to 24 weeks' gestation. In comparison, 75 458 (5.8%) of all Florida-born public school students were low performing; 310 (33.5%) of these children had been born at 23 to 24 weeks' gestation. Kindergarten readiness, FCAT scores, and gifted status were positively related to gestational age, whereas low performance was inversely related to gestational age.
Although gestational age has long been associated with poor educational performance, a sufficient proportion of children born near the limits of viability performed within expected school norms, warranting further investigation into how and why certain children are able to overcome the educational burdens that may follow preterm birth.
早产儿的幸存者通常会出现医疗并发症; 然而，他们在学校教育表现方面的差异尚未得到很好的描述。
评估胎龄与 4 项学龄儿童教育成果之间的关联：准备上幼儿园、小学和初中的标准化考试成绩、天赋和表现不佳。
设计、地点和参与者：在一项回顾性队列研究中，1992 年至 2002 年间在佛罗里达州出生，胎龄为 23 至 41 周，1995 年至 2012 年间进入佛罗里达州公立学校的儿童评估了他们的幼儿园准备情况，并在 3 年级至 8 年级进行了数学和阅读测试。数据分析于 2016 年 1 月 12 日至 2017 年 3 月 1 日进行。
出生时的胎龄。
幼儿园准备情况、佛罗里达州综合成就测试（FCAT）成绩、被归类为天赋和被归类为表现不佳。
共 1527113 名胎龄为 23 至 41 周的单胎婴儿于 1992 年至 2002 年出生，与佛罗里达州公立学校记录相匹配。其中，1301497 名儿童被纳入分析；641479 名（49.3%）为女孩。共有 301 名（65.0%）胎龄为 23 至 24 周的佛罗里达州儿童被指定为准备开始上幼儿园。当根据潜在的混杂产妇和婴儿变量调整 FCAT 测试分数时，胎龄为 23 至 24 周出生的儿童的表现比足月出生的儿童低 0.66 个标准差（95%CI，-0.73 至-0.59）。共有 123554 名（9.5%）所有在佛罗里达州出生的公立学校学生被认为是有天赋的，其中包括 23 至 24 周出生的 17 名（1.8%）。相比之下，所有在佛罗里达州出生的公立学校学生中，有 75458 名（5.8%）表现不佳；其中 310 名（33.5%）儿童胎龄为 23 至 24 周。幼儿园准备情况、FCAT 分数和天赋状况与胎龄呈正相关，而表现不佳与胎龄呈负相关。
尽管胎龄与不良教育表现长期相关，但相当一部分接近生存极限的儿童的表现符合学校预期规范，这需要进一步研究为什么某些儿童能够克服可能随之而来的早产儿教育负担。
