早产儿的长期教育效果。

IF 9.7 1区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Tianna Loose, Ophelie Collet, Anne Monique Nuyt, Jean-Christophe Goulet-Pelletier, Frank C Worrell, Sylvana Côté, Thuy Mai Luu
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引用次数: 0

摘要

重要性:早产儿童可能面临神经发育方面的挑战。关于这如何转化为人口层面的长期教育成果的数据很少。目的:量化早产和社会人口因素对教育成就的相对贡献。设计、环境和参与者:本病例对照研究包括1976年至1995年间加拿大魁北克省所有早产婴儿的出生队列,与足月出生婴儿的比例为1:2。在怀孕37周之前出生被认为是早产。在妊娠37至42周出生的对照组按出生年份、性别和妊娠类型(单胎、双胞胎)进行匹配。行政数据库连接为纵向随访到43岁提供了客观数据。在1976年至2019年期间死亡或没有魁北克教育部记录的个人被排除在外。分析时间为2023年2月2日至2025年6月4日。暴露:早产,定义为极度早产(少于28周),非常早产(28至28周)。主要结果和测量:结果包括高中成绩(高中毕业平均成绩),22岁高中毕业,以及任何年龄的大学学位。从魁北克出生和死亡登记处提取社会人口因素。社会经济地位是通过邮政编码和物质和社会剥夺指数得出的。结果:297 820名参与者(160 980名男性[54.0%];28 040名[9.4%]出生在加拿大境外的母亲)中,1915名(0.6%)极度早产,13 225名(4.4%)非常早产,83 105名(27.9%)中度至晚期早产,199 575名(67.0%)足月。在那些继续上学的学生中,早产和高中毕业平均成绩的关联可以忽略不计。胎龄与受教育程度呈剂量-反应模式相关,其中极度早产的个体未从高中毕业(OR, 1.80; 99% CI, 1.54-2.09)或未获得大学学位(OR, 1.68; 99% CI, 1.39-2.02)的风险最大。与男性性别、母亲受教育程度、社会经济地位和移民相关因素相比,早产的贡献较小。结论和相关性:在本病例对照研究中,早产个体比足月个体更有可能无法完成高中学业,但社会人口因素比早产状况对受教育程度更重要。我们的研究结果证实了对早产儿童及其家庭进行长期随访和支持的必要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Long-Term Educational Outcomes of Individuals Born Preterm.

Importance: Children born preterm may face neurodevelopmental challenges. Data on how this translates into long-term educational outcomes at the population level are scarce.

Objective: To quantify relative contributions of preterm birth and sociodemographic factors to educational achievement and attainment.

Design, setting, and participants: This case-control study included a birth cohort of all infants born preterm in Quebec, Canada, between 1976 and 1995, matched 1:2 with infants born term. Births before 37 weeks' gestations were considered preterm. The control cohort born between 37 and 42 weeks' gestation were matched by birth year, sex, and pregnancy type (singleton, twins). Administrative database linkages provided objective data for longitudinal follow-up to age 43 years. Individuals who died in 1976 to 2019 or without Quebec Ministry of Education records were excluded. Analyses were performed from February 2, 2023, to June 4, 2025.

Exposure: Preterm birth, defined as extremely preterm (under 28 weeks), very preterm (28 to <32 weeks), or moderate-to-late preterm (32 to <37 weeks).

Main outcomes and measures: Outcomes included high school performance (final high school average), high school graduation by age 22 years, and university degree at any age. Sociodemographic factors were extracted from the Quebec Births and Deaths registry. Socioeconomic status was derived using postal code and the Material and Social Deprivation Index.

Results: Of 297 820 participants (160 980 male [54.0%]; 28 040 individuals [9.4%] born to mothers born outside Canada), 1915 (0.6%) were born extremely preterm, 13 225 (4.4%) very preterm, 83 105 (27.9%) moderate-to-late preterm, and 199 575 (67.0%) full term. Associations of preterm birth and final high school average were negligible among those who remained in school. Gestational age was associated with educational attainment in a dose-response pattern wherein individuals born extremely preterm were the most at risk for not graduating high school (OR, 1.80; 99% CI, 1.54-2.09) or not obtaining a university degree (OR, 1.68; 99% CI, 1.39-2.02). The contribution of preterm birth was small compared with male sex, maternal educational level, socioeconomic status, and migration related factors.

Conclusions and relevance: In this case-control study, individuals born preterm were more likely than full-term counterparts to not complete high school, yet sociodemographic factors were more important than preterm status for educational attainment. Our findings substantiate the need for long-term follow-up and support to children born preterm and their families.

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来源期刊
JAMA Network Open
JAMA Network Open Medicine-General Medicine
CiteScore
16.00
自引率
2.90%
发文量
2126
审稿时长
16 weeks
期刊介绍: JAMA Network Open, a member of the esteemed JAMA Network, stands as an international, peer-reviewed, open-access general medical journal.The publication is dedicated to disseminating research across various health disciplines and countries, encompassing clinical care, innovation in health care, health policy, and global health. JAMA Network Open caters to clinicians, investigators, and policymakers, providing a platform for valuable insights and advancements in the medical field. As part of the JAMA Network, a consortium of peer-reviewed general medical and specialty publications, JAMA Network Open contributes to the collective knowledge and understanding within the medical community.
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