Maternal educational status at birth, maternal educational advancement, and neurocognitive outcomes at age 10 years among children born extremely preterm

BACKGROUND: To determine if a key marker of socioeconomic status, maternal education, is associated with later neurocognitive and academic outcomes among children born extremely preterm (EP). METHOD: Eight hundred and seventy three children born at 23 to 27 weeks of gestation were assessed for cognitive and academic ability at age 10 years. With adjustments for gestational age (GA) and potential confounders, outcomes of children whose mothers had fewer years of education at the time of delivery and children whose mother advanced in education between birth and 10 years were examined. RESULTS: Children of mothers in the lowest education stratum at birth were significantly more likely to score >= 2 SDs below normative expectation on 17 of 18 tests administered. Children of mothers who advanced in education (n = 199) were at reduced risk for scoring >= 2 SDs on 15 of 18 measures, but this reduction was statistically significant on only 2 of 18 measures. CONCLUSION: Among EP children, socioeconomic disadvantage at birth, indexed by maternal education, is associated with significantly poorer neurocognitive and academic outcomes at 10 years of age, independently of GA. Maternal educational advancement during the child's first 10 years of life is associated with modestly improved neurocognitive outcomes.