143 - Grade 7 School Performance of Children Born Preterm: A Retrospective Canadian Cohort Study

Sunday, April 30, 2023

3:30 PM – 6:00 PM ET

Poster Number: 143
Publication Number: 143.362

Hammam Akil, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Lisa M. Lix, University of Manitoba, Winnipeg, MB, Canada; Diane Moddemann, University of Manitoba, Winnipeg, MB, Canada; Allan Garland, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Mary Seshia, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Ruben Alvaro, University of Manitoba, Winnipeg, MB, Canada; Sapna Oberoi, CancerCare Manitoba, Winnipeg, MB, Canada; Deepak Louis, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; Monica Sirski, Manitoba Centre for Health Policy, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada

Presenting Author(s)

DEEPAK LOUIS, MD, DM (he/him/his)

Assistant Professor
Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba
Winnipeg, Manitoba, Canada

Background: Advancements in neonatal-perinatal medicine over the last few decades have resulted in an improving survival of extremely preterm neonates. Education is one of the various domains children born preterm face challenges in. Some of their developmental, cognitive, social and behavioral issues contribute to their educational challenges. These educational difficulties can have significant societal impact if they are not identified and supported promptly. Our previous work showed children born preterm having lower school readiness rates in kindergarten and poorer numeracy and reading outcomes in grade 3 compared to children born full term. Previous studies on the middle school performance of children born preterm are limited by small sample sizes, attrition bias, and residual confounding. The present study aims to address these limitations and expand on our prior work by examining the association between prematurity and grade 7 outcomes among a population-based cohort of children.

Objective: To test the association between prematurity (< 37 weeks gestational age) and grade 7 school performance.

Design/Methods: A retrospective population-based cohort study of children born in Manitoba, Canada between 1994-2006 whose grade 7 school performance data was available. A secondary sibling cohort was created consisting of children born preterm and their full-term sibling closest in age. There were two co-primary outcome measures, one addressing mathematics competencies and the other student engagement. Multivariable logistic regression models tested the association between prematurity and both primary outcomes; adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. However, no differences were observed among the sibling cohort.

Results:

Of 157322 eligible children, 117966 children were included [7653 preterm (gestational age median [IQR]: 35 weeks [34,36]) and 110313 term (40 [39,40]). Overall, 18% of children born preterm and 13% of those born full-term had the mathematics outcome (aOR: 1.35; 95% CI: 1.26-1.44, p < 0.001) while 23% and 20% had the engagement outcome, respectively (aOR: 1.13, 1.07-1.20, p < 0.001). Prematurity was associated with the mathematics (34-36 weeks: 1.26, 1.16-1.35; 28-33 weeks: 1.47, 1.27-1.70; < 28 weeks: 5.48, 3.89-7.70) and student engagement outcomes (34-36 weeks: 1.09, 1.01-1.16; 28-33 weeks: 1.21, 1.06-1.39; < 28 weeks: 2.49, 1.76-3.51).

Conclusion(s): Children born preterm had poorer grade 7 performance compared to children born full-term in this population-based cohort. Screening and supports for these children in their middle school years are warranted.