TY - JOUR
T1 - Academic performance of children born preterm: a meta-analysis and meta-regression
AU - Twilhaar, E. Sabrina
AU - de Kieviet, Jorrit F.
AU - Aarnoudse-Moens, Cornelieke S. H.
AU - van Elburg, Ruurd M.
AU - Oosterlaan, Jaap
PY - 2018
Y1 - 2018
N2 - Advances in neonatal healthcare have resulted in decreased mortality after preterm birth but have not led to parallel decreases in morbidity. Academic performance provides insight in the outcomes and specific difficulties and needs of preterm children. To study academic performance in preterm children born in the antenatal steroids and surfactant era and possible moderating effects of perinatal and demographic factors. PubMed, Web of Science and PsycINFO were searched for peer-reviewed articles. Cohort studies with a full-term control group reporting standardised academic performance scores of preterm children ( <37 weeks of gestation) at age 5 years or older and born in the antenatal steroids and surfactant era were included. Academic test scores and special educational needs of preterm and full-term children were analysed using random effects meta-analysis. Random effects meta-regressions were performed to explore the predictive role of perinatal and demographic factors for between-study variance in effect sizes. The 17 eligible studies included 2390 preterm children and 1549 controls. Preterm children scored 0.71 SD below full-term peers on arithmetic (p <0.001), 0.44 and 0.52 SD lower on reading and spelling (p <0.001) and were 2.85 times more likely to receive special educational assistance (95% CI 2.12 to 3.84, p <0.001). Bronchopulmonarydysplasia explained 44% of the variance in academic performance (p=0.006). Preterm children born in the antenatal steroids and surfactant era show considerable academic difficulties. Preterm children with bronchopulmonarydysplasia are at particular risk for poor academic outcome
AB - Advances in neonatal healthcare have resulted in decreased mortality after preterm birth but have not led to parallel decreases in morbidity. Academic performance provides insight in the outcomes and specific difficulties and needs of preterm children. To study academic performance in preterm children born in the antenatal steroids and surfactant era and possible moderating effects of perinatal and demographic factors. PubMed, Web of Science and PsycINFO were searched for peer-reviewed articles. Cohort studies with a full-term control group reporting standardised academic performance scores of preterm children ( <37 weeks of gestation) at age 5 years or older and born in the antenatal steroids and surfactant era were included. Academic test scores and special educational needs of preterm and full-term children were analysed using random effects meta-analysis. Random effects meta-regressions were performed to explore the predictive role of perinatal and demographic factors for between-study variance in effect sizes. The 17 eligible studies included 2390 preterm children and 1549 controls. Preterm children scored 0.71 SD below full-term peers on arithmetic (p <0.001), 0.44 and 0.52 SD lower on reading and spelling (p <0.001) and were 2.85 times more likely to receive special educational assistance (95% CI 2.12 to 3.84, p <0.001). Bronchopulmonarydysplasia explained 44% of the variance in academic performance (p=0.006). Preterm children born in the antenatal steroids and surfactant era show considerable academic difficulties. Preterm children with bronchopulmonarydysplasia are at particular risk for poor academic outcome
KW - Academic performance
KW - Arithmetic
KW - Cognition
KW - Meta-Analysis
KW - Neonatology
KW - Neurodevelopment
KW - Preterm birth
KW - Reading
KW - Spelling
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U2 - https://doi.org/10.1136/archdischild-2017-312916
DO - https://doi.org/10.1136/archdischild-2017-312916
M3 - Article
C2 - 28847871
SN - 1359-2998
VL - 103
SP - F322-330
JO - Archives of disease in childhood. Fetal and neonatal edition
JF - Archives of disease in childhood. Fetal and neonatal edition
IS - 4
M1 - 312916
ER -