de Baat Tessa, Ravelli Anita C J, Aarnoudse-Moens Cornelieke S H, Abu-Hanna Ameen, Leemhuis Aleid G
Department of Neonatology, Emma Children's Hospital, Amsterdam UMC, location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
Department of Obstetrics and Gynaecology, Reproductive and Development, Amsterdam UMC Location AMC, Amsterdam, The Netherlands.
Arch Dis Child Fetal Neonatal Ed. 2025 May 12. doi: 10.1136/archdischild-2025-328599.
To investigate the effect of gestational age on special education use at primary school age, and to examine specific groups with elevated risk.
DESIGN, SETTING AND PATIENTS: Population-based matched cohort study linking data from the Dutch national perinatal registry (PERINED) of all singleton surviving children without major congenital abnormalities, born between 25 and 42 weeks of gestation between 1999 and 2009, with data of the mandatory special education registry of Statistics Netherlands.
Use of special education at primary school age.
1 814 540 children were included. Overall prevalence of special education was 6.6%, with highest rates in children born at 25 weeks (34.7%) and lowest at 40 weeks (5.7%). Elevated adjusted ORs for special education compared with the reference of 40 weeks were found in all gestational age groups (25-29 weeks, 30-31 weeks, 32-36 weeks, 37-39 weeks and 41-42 weeks), with the highest adjusted OR (3.50 (95% CI, 3.26 to 3.77)) in children born at 25-29 weeks. Comparable ORs were obtained after 1 to 1 exact matching with controls born at 40 weeks. Low maternal education, male sex, small for gestational age and 5-min Apgar score<7 increased special education use at week 25 and above.
There is a strong inverse effect of gestational age on special education use in this complete nationwide, decennium birth cohort. Increased risk of special education use is still present in late preterms and those born at early-term or post-term.
探讨胎龄对小学适龄儿童接受特殊教育的影响，并检查风险升高的特定群体。
设计、背景与患者：基于人群的匹配队列研究，将1999年至2009年期间在荷兰国家围产期登记处（PERINED）登记的所有单胎存活且无重大先天性异常、孕周在25至42周之间出生的儿童数据，与荷兰统计局强制性特殊教育登记处的数据相链接。
小学适龄儿童接受特殊教育的情况。
纳入了1814540名儿童。特殊教育的总体患病率为6.6%，在25周出生的儿童中患病率最高（34.7%），在40周出生的儿童中患病率最低（5.7%）。在所有孕周组（25 - 29周、30 - 31周、32 - 36周、37 - 39周和41 - 42周）中，与40周出生的儿童作为参考相比，特殊教育的校正比值比均升高，其中25 - 29周出生的儿童校正比值比最高（3.50（95%CI，3.26至3.77））。与40周出生的对照进行1对1精确匹配后获得了类似的比值比。母亲教育程度低、男性、小于胎龄儿以及5分钟阿氏评分<7会增加25周及以上孕周儿童接受特殊教育的几率。
在这个完整的全国性十年出生队列中，胎龄对特殊教育的使用有很强的反向影响。晚期早产儿以及足月或过期产儿接受特殊教育的风险仍然较高。
