Children born just a few weeks prematurely, who consequently fall into an earlier school year, are more likely to experience significant setbacks in their education after their first year of school, according to a new study from the University of Leeds in England.
The findings are published in the journal Archives of Disease in Childhood.
“Some children born prematurely not only have to contend with having spent less time developing in the womb but also have to start school a year earlier than they would have, had they been born on their due date,” said coauthor Dr. Liam Hill from the University of Leeds’ School of Psychology. “This amounts to having less time also developing outside of the womb at the point they start school.”
“This can pose additional challenges right from the start of their education, and we found this can have an immediate impact on their performance, after just one year of school.”
Previous research has shown that children born severely prematurely more than ten weeks early — are more likely to experience educational problems. But the new work highlights the disadvantage that children who were born moderately premature may face, who were believed to be at a lower risk.
In the new study, the researchers evaluated the complex interplay between the educational drawbacks of being born moderately premature, along with what time of the year the child was born, to understand whether extra support might be necessary.
The researchers looked at the data of more than 10,000 school children from the Born in Bradford birth cohort study and found that the odds of a prematurely-born child not achieving a “good level of development” by the end of the reception, were approximately twice as high as those for children born at full term.
The children found to be most at risk were those born prematurely in the summer months (June to August), who consequently started school a year earlier than expected.
These kids were three times less likely to reach a good level of development compared to other children born prematurely during the summer, whose early arrival didn’t change the year in which they started school.
However, the researchers found some evidence suggesting that holding premature children back from starting school by a year may not compensate for being born prematurely — although they did not test that directly.
“Whilst it seems like an obvious solution, delayed entry for premature children is not likely to compensate for being born early, as we found that within a given school year, the risks to development faced by children born premature did not vary depending on when within that school year they were born,” said coauthor Dr. Katherine Pettinger, a neonatal doctor from Born in Bradford and the Bradford Teaching Hospitals NHS Foundation Trust.
“To try to better support this at risk group we instead suggest that schools should be informed which of their pupils were born prematurely so they can be given extra support, particularly early on in their schooling.”
According to England’s national guidelines, once discharged from the hospital, severely premature children are given follow-up medical support, and it is recommended that their schools are informed of their circumstances. But for moderately premature children, born between three to eight weeks early, there is no routine follow up support offered, so schools are unlikely to be informed.
Overall, the team argues that from an early age there is a complex interplay between health and education, which should help encourage education providers to move away from arbitrary decision making, towards a more targeted, personalized approach.
Source: University of Leeds