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School performance at nine years of age in very premature and very low birth weight infants : Perinatal risk factors and predictors at five years of age

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Author: Hille, E.T.M. · Ouden, A.L. den · Bauer, L. · Oudenrijn, C. van den · Brand, R. · Verloove-Vanhorick, S.P.
Type:article
Date:1994
Institution: Nederlands Instituut voor Praeventieve Gezondheidszorg TNO
Source:Journal of Pediatrics, 3, 125, 426-434
Identifier: 232430
Keywords: Health · Academic achievement · Development · Major clinical study · Newborn · Prediction · Prematurity · Prognosis · School child · Sex difference · Small for date infant · Social status · Very low birth weight · Birth Weight · Child · Child Development · Child, Preschool · Cohort Studies · Disabled Persons · Education, Special · Educational Status · Female · Follow-Up Studies · Forecasting · Gestational Age · Human · Infant, Low Birth Weight · Infant, Newborn · Infant, Premature · Infant, Small for Gestational Age · Mainstreaming (Education) · Male · Mental Retardation · Risk Factors · Social Class · Support, Non-U.S. Gov't · Survival Rate

Abstract

To assess the impact of both perinatal disorders and developmental problems identified at preschool age on school performance, we followed a virtually complete birth cohort of very premature (<32 completed weeks of gestation) and very low birth weight infants until they were 9 years of age. In 84% of the survivors (n = 813), data on school performance were available for analysis. At the age of 9 years, 19% of the children were in special education. Of the children in mainstream education, 32% were in a grade below the appropriate level for age and 38% had special assistance. After correction for other perinatal items, children of low socioeconomic status and boys had significantly higher adjusted odds ratios for special education. Logistic regression with a perinatal and a 5-year time category showed that the most predictive factors for-special education were developmental delay, neuromotor and speech/language function, inattention and hyperactivity score, total problem score, and reported school results at the age of 5 years. When children with disabilities were left out of the analysis, the importance of neuromotor function and total problem score disappeared. Increased risks of any school failure in nondisabled children included mild or severe developmental delay and marginal or poor school performance at the age of 5 years. Long-term follow-up with specific attention to these predictors at 5 years of age, although time-consuming, is necessary.