Seppänen Anna-Veera, Pierrat Véronique, Marchand-Martin Laetitia, Charkaluk Marie-Laure, Muller Jean-Baptiste, Marret Stéphane, Zeitlin Jennifer, Sentenac Mariane
Université Paris Cité, INSERM UMR 1153, Centre for Research in Epidemiology and Statistics (CRESS), Obstetric, Perinatal, Paediatric Life Course Epidemiology Research Team (OPPaLE), Paris, France.
Réanimation et Médecine Néonatale, Centre Hospitalier Intercommunal de Créteil, Créteil, France.
Pediatr Res. 2025 Aug 4. doi: 10.1038/s41390-025-04287-4.
Children born preterm face higher risks of neurodevelopmental difficulties that, with social vulnerabilities, may impair school performance. We described and assessed determinants of receiving school support in preterm-born children in France.
We used data from the prospective population-based cohort of births before 35 weeks' gestation in France, EPIPAGE-2, to estimate crude rates and adjusted relative risks (using multivariable, mixed-effects generalized linear models) of receiving school support at age five, by children's neurodevelopment at five, sociodemographic characteristics, and region.
Out of 3,007 children, 99% attended mainstream school at age five, of whom 9% received school support. Support was more often received by boys (11%; aRR = 1.37) than girls (6%), children born at 24-27 weeks' gestation (21%; aRR = 2.78 compared to 32-34 weeks), and children with moderate or severe neurodevelopmental impairments (MSNDI: cerebral palsy, cognitive impairment, visual impairment or blindness, and/or hearing impairment or deafness) (39%; aRR = 17.25 compared to none). Receiving support was not associated with sociodemographic characteristics, after adjusting for covariates.
Neurodevelopmental impairment is a key determinant for receiving school support. However, 9% of the cohort and under 40% of children with MSNDI were receiving support, raising questions on whether unmet needs for school support exist in France.
This study provides an overview of school support received at age five by children born before 35 weeks' gestation in France, and associated determinants Less than 10% of the total cohort and 40% of children with a moderate or severe neurodevelopmental impairment were receiving school support Cognitive and neurodevelopmental impairments were key determinants for receiving school support, but sociodemographic characteristics were not Our results raise questions about whether unmet needs for school support exist, calling for further research on the support available in schools, decision-making processes for allocating them, and the psychosocial and academic consequences of their provision on children.
早产出生的儿童面临更高的神经发育困难风险，这些困难加上社会脆弱性，可能会影响学业表现。我们描述并评估了法国早产儿童接受学校支持的决定因素。
我们使用了来自法国EPIPAGE-2前瞻性基于人群的妊娠35周前出生队列的数据，通过儿童五岁时的神经发育、社会人口学特征和地区，估计五岁时接受学校支持的粗率和调整后的相对风险（使用多变量、混合效应广义线性模型）。
在3007名儿童中，99%在五岁时进入主流学校，其中9%接受学校支持。男孩（11%；调整后相对风险=aRR=1.37）比女孩（6%）、妊娠24-27周出生的儿童（21%；与32-34周出生的儿童相比，aRR=2.78）以及有中度或重度神经发育障碍（MSNDI：脑瘫、认知障碍、视力障碍或失明和/或听力障碍或失聪）的儿童（39%；与无此类障碍的儿童相比，aRR=17.25）更常接受支持。在调整协变量后，接受支持与社会人口学特征无关。
神经发育障碍是接受学校支持的关键决定因素。然而，该队列中有9%的儿童以及MSNDI儿童中不到40%的儿童正在接受支持，这引发了关于法国是否存在未满足的学校支持需求的问题。
本研究概述了法国妊娠35周前出生的儿童在五岁时接受的学校支持及其相关决定因素。整个队列中不到10%的儿童以及40%有中度或重度神经发育障碍的儿童正在接受学校支持。认知和神经发育障碍是接受学校支持的关键决定因素，但社会人口学特征不是。我们的结果引发了关于是否存在未满足的学校支持需求的问题，呼吁对学校提供的支持、分配支持的决策过程以及提供支持对儿童的心理社会和学业影响进行进一步研究。
