The trajectories of late preterm development from infancy to kindergarten reading and math, and predictors of academic resilience and risk are unknown.
Sample included 1200 late preterm infants (LPIs) from the Early Childhood Longitudinal Study, Birth Cohort. Objective measurements of development at 9 and 24 months (Bayley-SFR) and reading and math academic achievement at preschool and kindergarten were standardized; trajectories of late preterm development from 9 months to kindergarten reading and math were identified using latent class growth analysis. Multinomial logistic regression [aOR, 95% CI] identified predictors of academic resilience and risk.
Four trajectory groups were observed for reading and three for math. More optimal trajectories (in reading and math) and academic resilience were associated with experiencing sensitive parenting and preschool attendance. Suboptimal (at-risk) trajectories (in reading or math) and an increased odds of academic risk were associated with <high school education, twin/multiple gestation, prenatal smoking and male sex.
LPI trajectories varied from infancy to kindergarten. More sensitive parenting and preschool attendance predicted academic resilience, and should be encouraged. Select risk factors (prenatal smoking, twin/multiple gestation, male sex, <high school education) predicted academic risk, and can help identify LPIs who might benefit from closer monitoring prior to school entry.
Late preterm infants (LPIs) have developmental risks compared to full terms. LPI trajectories of early reading and math varied from infancy to kindergarten. We identified predictors of academic resilience and risk, which can help inform anticipatory guidance provided to LPIs prior to kindergarten.
Promotive factors (sensitive parenting and preschool enrollment) predicted academic resilience. Select maternal and neonatal characteristics (<high school education, male sex, prenatal smoking, and multiple gestation) predicted academic risk at kindergarten.
LPIs account for the majority of preterm infants. Encouraging preschool enrollment and fostering sensitive parenting may promote early academic achievement in LPIs, which has population-level impacts.
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Data for this study were obtained from the Early Childhood Longitudinal Study-Birth Cohort, restricted-use dataset. Data can be accessed after entering into a data use agreement with the Institute of Educational Statistics, National Center for Educational Statistics.
Davidoff, M. et al. Changes in the gestational age distribution among US singleton births: Impact on rates of late preterm birth, 1992 to 2002. Semin. Perinatol. 30, 8–15 (2006).
Raju, T. N. K., Higgins, R. D., Stark, A. R. & Leveno, K. J. Optimizing care and outcome for late-preterm (near-term) infants: a summary of the workshop sponsored by the National Institute of Child Health and Human Development. Pediatrics 118, 1207–1214 (2006).
Shah, P., Kaciroti, N., Richards, B., Oh, W. & Lumeng, J. C. Developmental outcomes of late preterm infants from infancy to kindergarten. Pediatrics 138, e20153496. https://doi.org/10.1542/peds.2015-3496 (2016).
Williams, B. L. et al. Perinatal origins of first-grade academic failure: role of prematurity and maternal factors. Pediatrics 131, 693 (2013).
Chan, E. & Quigley, M. A. School performance at age 7 years in late preterm and early term birth: a cohort study. Arch. Dis. Child. Fetal Neonatal Ed. 99, F451–F457 (2014).
Shah, P. E., Kaciroti, N., Richards, B. & Lumeng, J. C. Gestational age and kindergarten school readiness in a national sample of preterm infants. J. Pediatr. 178, 61–67 (2016).
Garfield, C. F. et al. Educational performance of children born prematurely. JAMA Pediatr. 171, 764–770 (2017).
Dollar, J. M., Perry, N. B., Calkins, S. D., Keane, S. P. & Shanahan, L. Temperamental anger and positive reactivity and the development of social skills: implications for academic competence during preadolescence. Early Educ. Dev. 29, 747–761 (2018).
Kalia, J. L., Visintainer, P., Brumberg, H. L., Pici, M. & Kase, J. Comparison of enrollment in interventional therapies between late-preterm and very preterm infants at 12 months’ corrected age. Pediatrics 123, 804–809 (2009).
Woodward, L. J., Clark, C. A., Bora, S. & Inder, T. E. Neonatal white matter abnormalities an important predictor of neurocognitive outcome for very preterm children. PLoS One 7, e51879 (2012).
Mangin, K. S., Horwood, L. J. & Woodward, L. J. Cognitive development trajectories of very preterm and typically developing children. Child Dev. 88, 282–298 (2017).
Erdei, C., Austin, N. C., Cherkerzian, S., Morris, A. R. & Woodward, L. J. Predicting school-aged cognitive impairment in children born very preterm. Pediatrics 145, e20191982. https://doi.org/10.1542/peds.2019-1982 (2020).
Linsell, L., Malouf, R., Morris, J., Kurinczuk, J. J. & Marlow, N. Prognostic factors for poor cognitive development in children born very preterm or with very low birth weight: a systematic review. JAMA Pediatr. 169, 1162–1172 (2015).
Poehlmann-Tynan, J. et al. Risk and resilience in preterm children at age 6. Dev. Psychopathol. 27, 843–858 (2015).
Faure, N. et al. Maternal sensitivity: a resilience factor against internalizing symptoms in early adolescents born very preterm? J. Abnorm. Child Psychol. 45, 671–680 (2017).
Wolke, D., Jaekel, J., Hall, J. & Baumann, N. Effects of sensitive parenting on the academic resilience of very preterm and very low birth weight adolescents. J. Adolesc. Health 53, 642–647 (2013).
Treyvaud, K. et al. Parenting behavior at 2 years predicts school-age performance at 7 years in very preterm children. J. Child Psychol. Psychiatry 57, 814–821 (2016).
Nguyen, T. N. et al. Language skills in children born preterm (<30 wks’ gestation) throughout childhood: associations with biological and socioenvironmental factors. J. Dev. Behav. Pediatr. 40, 735–742 (2019).
ElHassan, N. O. et al. The impact of prematurity and maternal socioeconomic status and education level on achievement-test scores up to 8th grade. PLoS One 13, e0198083 (2018).
Chen, J. H., Claessens, A. & Msall, M. E. Prematurity and school readiness in a nationally representative sample of Australian children: does typically occurring preschool moderate the relationship. Early Hum. Dev. 90, 73–79 (2014).
Reid, L. D. & Strobino, D. M. A population-based study of school readiness determinants in a large urban public school district. Matern Child Health J. 23, 325–334 (2019).
Girsen, A. I., Do, S. C., El-Sayed, Y. Y., Hintz, S. R. & Blumenfeld, Y. J. Association between small-for-gestational age and neurocognitive impairment at two years of corrected age among infants born at preterm gestational ages: a cohort study. J. Perinatol. 37, 958–962 (2017).
Potijk, M. R., Kerstjens, J. M., Bos, A. F., Reijneveld, S. A. & de Winter, A. F. Developmental delay in moderately preterm-born children with low socioeconomic status: risks multiply. J. Pediatr. 163, 1289–1295 (2013).
Brown, H. K., Speechley, K. N., Macnab, J., Natale, R. & Campbell, M. K. Mild prematurity, proximal social processes, and development. Pediatrics 134, e814–e824 (2014).
Johnson, S. et al. Differentiating the preterm phenotype: distinct profiles of cognitive and behavioral development following late and moderately preterm birth. J. Pediatr. 193, 85–92.e81 (2018).
Nord, C., Edwards, B., Andreassen, C., Green, J. L., Wallner-Allen, K. Early Childhood Longitudinal Study, Birth Cohort (ECLS-B), User’s Manual for the ECLS-B Longitudinal 9-Month: 2-Year Data File and Electronic Codebook (NCES 2006-046) (US Department of Education, National Center for Education Statistics, 2006).
Bayley, N. Bayley Scales of Infant and Toddler Development 2nd edn (Harcourt Assessment, 1993).
Snow K, et al. Early Childhood Longitudinal Study, Birth Cohort (ECLS-B) 9-Month—Preschool Restricted-Use Data File and Electronic Codebook. In: U.S. Department of Education NCES, ed. Washington, DC: U.S. Department of Education; 2007.
Snow, K. et al. Early Childhood Longitudinal Study, Birth Cohort (ECLS-B) Kindergarten 2006 and 2007 Data File User’s Manual (2010-010). In: Statistics NCES, editor. Washington, D.C.: Institute of Educational Sciences, U.S. Department of Education; 2009.
Magidson, J. & Vermunt, J. K. in The Sage Handbook of Quantitative Methodology for the Social Sciences 175–198; Sage Publications, (2004).
Jones, B. L., Nagin, D. S. & Roeder, K. A SAS procedure based on mixture models for estimating developmental trajectories. Sociol. Methods Res. 29, 374–393 (2001).
Nagin, D. S. & Nagin, D. Group-Based Modeling of Sevelopment (Harvard University Press, 2005).
Base SAS(R) 9.4 Procedures Guide: Statistical Procedures (Cary, NC 2014).
Munoz-Moreno, E. et al. Structural brain network reorganization and social cognition related to adverse perinatal condition from infancy to early adolescence. Front. Neurosci. 10, 560 (2016).
Oros, D. et al. Pathways of neuronal and cognitive development in children born small-for-gestational age or late preterm. Ultrasound Obstet. Gynecol. 43, 41–47 (2014).
Walsh, J. M., Doyle, L. W., Anderson, P. J., Lee, K. J. & Cheong, J. L. Y. Moderate and late preterm birth: effect on brain size and maturation at term-equivalent age. Radiology 273, 232–240. https://doi.org/10.1148/radiol.14132410 (2014).
Shonkoff, J. P., Boyce, W. T., Levitt, P., Martinez, F. D. & McEwen, B. Leveraging the biology of adversity and resilience to transform pediatric practice. Pediatrics 147, e20193845 (2021).
Bodeau-Livinec, F. et al. Do very preterm twins and singletons differ in their neurodevelopment at 5 years of age? Arch. Dis. Child. Fetal Neonatal Ed. 98, F480–F487 (2013).
Kristjansson, A. L. et al. Maternal smoking during pregnancy and academic achievement of offspring over time: a registry data-based cohort study. Prev. Med. 113, 74–79 (2018).
Weis, M., Heikamp, T. & Trommsdorff, G. Gender differences in school achievement: the role of self-regulation. Front. Psychol. 4, 442 (2013).
Spets, D. S., Jeye, B. M. & Slotnick, S. D. Different patterns of cortical activity in females and males during spatial long-term memory. Neuroimage 199, 626–634 (2019).
Liu, L. L., Benner, A. D., Lau, A. S. & Kim, S. Y. Mother-adolescent language proficiency and adolescent academic and emotional adjustment among Chinese American families. J. Youth Adolesc. 38, 572–586 (2009).
Han, W. J. Bilingualism and academic achievement. Child Dev. 83, 300–321 (2012).
Juffer, F., Struis, E., Werner, C. & Bakermans-Kranenburg, M. J. Effective preventive interventions to support parents of young children: illustrations from the Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD). J. Prev. Interv. Community 45, 202–214 (2017).
Mendelsohn, A. L. et al. Use of videotaped interactions during pediatric well-child care: impact at 33 months on parenting and on child development. J. Dev. Behav. Pediatr. 28, 206 (2007).
Garner, A. & Yogman, M. Preventing childhood toxic stress: partnering with families and communities to promote relational health. Pediatrics 148, e2021052582. https://doi.org/10.1542/peds.2021-052582 (2021).
Gueron-Sela, N., Atzaba-Poria, N., Meiri, G. & Marks, K. The caregiving environment and developmental outcomes of preterm infants: diathesis stress or differential susceptibility effects. Child Dev. 86, 1014–1030 (2015).
Poehlmann, J. et al. Preterm infants who are prone to distress: differential effects of parenting on 36-month behavioral and cognitive outcomes. J. Child Psychol. Psychiatry 53, 1018–1025 (2012).
Jaekel, J. & Wolke, D. Preterm birth and dyscalculia. J. Pediatr. 164, 1327–1332 (2014).
Labayru, G. et al. Small for gestational age moderate to late preterm children: a neuropsychological follow-up. Dev. Neuropsychol. 46, 277–287 (2021).
Suikkanen, J. et al. Reaction times, learning, and executive functioning in adults born preterm. Pediatr. Res. 89, 198–204 (2021).
Martínez-Nadal, S. & Bosch, L. Cognitive and learning outcomes in late preterm infants at school age: a systematic review. Int. J. Environ. Res. Public Health 18, 74 (2021).
Hack, K. E. et al. Long-term neurodevelopmental outcome of monochorionic and matched dichorionic twins. PLoS One 4, e6815 (2009).
Williams, P. G. & Lerner, M. A. School readiness. Pediatrics 144, e20191766 (2019).
Council on Early Childhood. The pediatrician’s role in optimizing school readiness. Pediatrics 138, e20162293. https://doi.org/10.1542/peds.2016-2293 (2016).
University of Michigan, NICHD (K08HD078506).
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Shah, P.E., Poehlmann, J., Weeks, H.M. et al. Developmental trajectories of late preterm infants and predictors of academic performance. Pediatr Res (2023). https://doi.org/10.1038/s41390-023-02756-2
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