Gestational Age, Parent Education, and Education in Adulthood

Abstract

BACKGROUND: Adults born preterm (<37 weeks) have lower educational attainment than those born term. Whether this relationship is modified by family factors such as socioeconomic background is, however, less well known. We investigated whether the relationship between gestational age and educational attainment in adulthood differed according to parents’ educational level in 4 Nordic countries. METHODS: This register-based cohort study included singletons born alive from 1987 up to 1992 in Denmark, Finland, Norway, and Sweden. In each study population, we investigated effect modification by parents’ educational level (low, intermediate, high) on the association between gestational age at birth (25–44 completed weeks) and low educational attainment at 25 years (not having completed upper secondary education) using general estimation equations logistic regressions. RESULTS: A total of 4.3%, 4.0%, 4.8%, and 5.0% singletons were born preterm in the Danish (n = 331 448), Finnish (n = 220 095), Norwegian (n = 292 840), and Swedish (n = 513 975) populations, respectively. In all countries, both lower gestational age and lower parental educational level contributed additively to low educational attainment. For example, in Denmark, the relative risk of low educational attainment was 1.84 (95% confidence interval 1.44 to 2.26) in adults born at 28 to 31 weeks whose parents had high educational level and 5.25 (95% confidence interval 4.53 to 6.02) in adults born at 28 to 31 weeks whose parents had low educational level, compared with a reference group born at 39 to 41 weeks with high parental educational level. CONCLUSIONS: Although higher parental education level was associated with higher educational attainment for all gestational ages, parental education did not mitigate the educational disadvantages of shorter gestational age.

Comparison of the outcomes of normal vaginal delivery with and without spinal anesthesia in mothers admitted to the maternity ward of Firoozabadi Hospital

“…Also, another study on vaginal delivery with and without anesthesia showed that the study groups in the second phase of labor were not significantly different but were different from each other in terms of the active labor phase. [ 26 27 28 ] It is noteworthy that the results of this study on the second stage of labor were not consistent with the results of our study, but the results of the active phase of labor in this study were consistent with our findings.…”

Neonatal Outcome and Treatment Perspectives of Preterm Infants at the Border of Viability

“…Parental education and socioeconomic status have been described as risk factors for the poorer neurodevelopmental outcome of preterm infants. In a recent study, parental educational level did not modify the relationship between gestational age and educational attainment in adulthood, although across all gestational age groups up to term age, lower parental education level was associated with lower educational attainment at 25 years [23].…”

“…Other factors beyond gestational age impact the prognosis, including baseline factors, such as antenatal steroids [18,19], gender [20,21], birth weight [21,22], possibly socioeconomic status [23] and factors not attributable to the individual case but the centre practice [24] and attitudes [25].…”

Cognitive and academic outcomes of large-for-gestational-age babies born at early-term: a systematic review and meta-analysis

“…independently graded evidence according to the GRADE handbook 33 . The strength of evidence was initially set as low and was rated up for 1) large effect sizes (Relative risk <0.5 or >2, and SMD<-0.25 or >0.25), 2) where a dose-response relationship was shown, and 3) effect of plausible residual confounding (such as parental education level ) 34 was considered. The strength of evidence was classified as very low, low, moderate, or high quality.…”