4.7 Article

Maternal education and cognitive development in 15 European very-preterm birth cohorts from the RECAP Preterm platform

Journal

INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
Volume 50, Issue 6, Pages 1824-1839

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/ije/dyab170

Keywords

Very-preterm births; child development; IQ; intelligence; maternal education; cohort

Funding

  1. European Union's Horizon 2020 research and innovation programme [733280]
  2. Italian Ministry of Health [RF-2009-1511846]
  3. Chiesi Farmaceutici S.p.a.
  4. German FederalMinistry of Education and Science (BMBF) [PKE24, JUG14, 01EP9504, 01ER0801]
  5. Medical Research Council [G0401525, MR/N024869/1]
  6. Department of Health's NIHR Biomedical Research Centre's funding scheme at UCLH/UCL
  7. Inserm (national Institute of Health and Medical Research)
  8. Directorate General for Health at the Ministry for Social Affairs, Merck-Sharp and Dohme-Chibret
  9. Medical Research Fondation
  10. French Department of Health [AOM01117']
  11. French National Institute of Public Health Research [IRESP TGIR 2009-01]
  12. French Health Ministry
  13. National Institute of Health and Medical Research (Inserm)
  14. National Institute of Cancer
  15. National Solidarity Fund for Autonomy (CNSA)
  16. National Research Agency through the French EQUIPEX program of investments for the future [ANR11-EQPX-0038]
  17. PremUp Foundation
  18. Fondation pour la Recherche Medicale [SPF 20160936356]
  19. Fondation de France [00050329, R18202KK]
  20. European Union [259882, 633724]
  21. Estonian Research Council [ETF7094]
  22. Estonian Ministry of Education and Research [SF0182695s05, SF0180004s11]
  23. Swedish Research Council [2006-3858, 2009-4250]
  24. Western Norway Regional Health Authority
  25. Haukeland University Hospital

Ask authors/readers for more resources

Studies indicate that regardless of the degree of prematurity, low maternal education is associated with lower cognition in children born very preterm.
Background: Studies are sparse and inconclusive about the association between maternal education and cognitive development among children born very preterm (VPT). Although this association is well established in the general population, questions remain about its magnitude among children born VPT whose risks of medical and developmental complications are high. We investigated the association of maternal education with cognitive outcomes in European VPT birth cohorts. Methods: We used harmonized aggregated data from 15 population-based cohorts of children born at <32 weeks of gestational age (GA) or <1500 g from 1985 to 2013 in 13 countries with information on maternal education and assessments of general development at 2-3 years and/or intelligence quotients between 4 and 15 years. Term-born controls (>= 37 weeks of GA) were available in eight cohorts. Maternal education was classified as: low (primary/lower secondary); medium (upper secondary/short tertiary); high (bachelor's/higher). Pooled standardized mean differences (SMDs) in cognitive scores were estimated (reference: high educational level) for children assessed at ages 2-3, 4-7 and 8-15 years. Results: The study included 10 145 VPT children from 12 cohorts at 2-3 years, 8829 from 12 cohorts at 4-7 years and 1865 children from 6 cohorts at 8-15 years. Children whose mothers had low, compared with high, educational attainment scored lower on cognitive measures [pooled unadjusted SMDs: 2-3 years = -0.32 (95% confidence intervals: -0.43 to -0.21); 4-7 years = -0.57 (-0.67; -0.47); 8-15 years = -0.54 (-0.72; -0.37)]. Analyses by GA subgroups (<27 vs >= 27 weeks) in children without severe neonatal morbidity and term controls yielded similar results. Conclusions: Across diverse settings and regardless of the degree of prematurity, low maternal education was associated with lower cognition.

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