Department of Obstetrics and Gynecology, Herlev and Gentofte Hospital, Herlev, Denmark.
Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
Acta Obstet Gynecol Scand. 2024 May;103(5):850-861. doi: 10.1111/aogs.14796. Epub 2024 Feb 13.
Worldwide, more children than before survive preterm birth. Preterm birth can affect long-term cognitive outcomes. The aim of our study was to investigate the association between preterm birth and academic performance and intelligence in youth.
This cohort study included all liveborn children in Denmark from 1978 to 2000. We used uni- and multivariable logistic and linear regressions to analyze associations between gestational age and school graduation, grade point average (GPA), attending conscription, and male intelligence scores at conscription. We adjusted for a priori defined potential confounders.
The study included 1 450 681 children and found an association between preterm birth and lower academic performance, with children born extremely preterm having the lowest odds of graduating from lower- and upper secondary education (LSE and USE) and appearing before the conscription board (odds ratios of 0.45 [0.38-0.54], 0.52 [0.46-0.59], and 0.47 [0.39-0.56] for LSE, USE, and conscription, respectively, compared to the term group). Statistically significant differences were observed in LSE for total GPA and core subject GPA with higher GPAs in the term group, which were considered clinically relevant for mathematics with a 0.71 higher grade point for the term compared to the extremely preterm. Conversely, USE differences were less evident, and in linear regression models we found that preterm birth was associated with higher GPAs in the adjusted analyses; however, this was not statistically significant. We demonstrated statistically significant differences in intelligence scores at conscription with lower scores in the three preterm groups (-5.13, -2.73, and - 0.76, respectively) compared to the term group.
Low gestational age at birth was associated with not graduating from LSE and USE, achieving lower GPAs in LSE, not attending conscription, and lower intelligence scores in young adulthood. The findings remained significant after adjusting for potential confounders.
在全球范围内，存活的早产儿数量比以往任何时候都多。早产儿出生可能会影响长期认知结果。我们研究的目的是调查早产儿与青少年学业成绩和智力之间的关系。
本队列研究纳入了 1978 年至 2000 年期间丹麦所有活产儿。我们使用单变量和多变量逻辑回归和线性回归来分析胎龄与毕业、平均绩点（GPA）、兵役登记以及兵役登记时男性智力得分之间的关系。我们调整了预先定义的潜在混杂因素。
该研究纳入了 1450681 名儿童，发现早产儿出生与较低的学业成绩相关，极早产儿毕业于高中和大学的可能性最低（下等和上等中等教育（LSE 和 USE）以及兵役登记的几率分别为 0.45 [0.38-0.54]、0.52 [0.46-0.59]和 0.47 [0.39-0.56]，与足月组相比）。在 LSE 的总 GPA 和核心科目 GPA 中，我们观察到统计学上显著的差异，足月组的 GPA 较高，与极早产儿相比，数学成绩高 0.71 个等级，被认为具有临床意义。相反，USE 的差异不明显，在线性回归模型中，我们发现调整后的分析中早产与 GPA 较高相关；然而，这在统计学上并不显著。我们在兵役登记时的智力测验分数中发现了统计学上的显著差异，与足月组相比，三个早产组的分数分别低了 5.13、2.73 和 0.76。
出生时的低胎龄与未完成 LSE 和 USE 学业、LSE 中 GPA 较低、未参加兵役登记以及青年期智力得分较低有关。在调整潜在混杂因素后，这些发现仍然具有统计学意义。
