The role of parental education on the relationship between gestational age and school outcomes

Preterm children born below 33-35 weeks of gestation have an increased risk of mathematical difficulties

AIM

To investigate the association between gestational age (GA) and grade point averages by domains of language and mathematics at the end of lower secondary education.

METHODS

A nationwide register-based study including all Danish children born in 1992-1997 who completed lower secondary education. Grades were evaluated by GA. Domain-specific differences in grades were investigated, and academic profiles were made.

RESULTS

The study population comprised 319 796 children. For language, only minor differences in grades were observed. The grades in mathematics ranged from 7.02 (95% confidence interval [CI]: 7.00-7.04) at GA = 40 weeks to 5.86 (95% CI: 5.61-6.11) at GA <28 weeks. Grade differences showed lower grades in mathematics, compared to language, below GA 33-35 weeks. The academic profile of mathematical difficulties was more prevalent among GA <32 weeks. Average/high grades within both domains represented the predominant academic profile, constituting 68.8% at GA 39-41 weeks and 56.6% at GA <28 weeks.

CONCLUSION

Only in mathematics decreasing GA was associated with lower grades. Increased mathematical difficulties were found below GA 33-35 weeks. The academic profile of mathematical difficulties was more prevalent among GA <32 weeks. However, the absolute differences in grades were small, and the predominant academic profile was average/high grades within both domains across all GA.

Prenatal and Postnatal Maternal Depressive Symptoms Are Associated With White Matter Integrity in 5-Year-Olds in a Sex-Specific Manner

BACKGROUND

Prenatal and postnatal maternal psychological distress predicts various detrimental consequences on social, behavioral, and cognitive development of offspring, especially in girls. Maturation of white matter (WM) continues from prenatal development into adulthood and is thus susceptible to exposures both before and after birth.

METHODS

WM microstructural features of 130 children (mean age, 5.36 years; range, 5.04-5.79 years; 63 girls) and their association with maternal prenatal and postnatal depressive and anxiety symptoms were investigated with diffusion tensor imaging, tract-based spatial statistics, and regression analyses. Maternal questionnaires were collected during first, second, and third trimesters and at 3, 6, and 12 months postpartum with the Edinburgh Postnatal Depression Scale (EPDS) for depressive symptoms and Symptom Checklist-90 for general anxiety. Covariates included child's sex; child's age; maternal prepregnancy body mass index; maternal age; socioeconomic status; and exposures to smoking, selective serotonin reuptake inhibitors, and synthetic glucocorticoids during pregnancy.

RESULTS

Prenatal second-trimester EPDS scores were positively associated with fractional anisotropy in boys (p < .05, 5000 permutations) after controlling for EPDS scores 3 months postpartum. In contrast, postpartum EPDS scores at 3 months correlated negatively with fractional anisotropy (p < .01, 5000 permutations) in widespread areas only in girls after controlling for prenatal second-trimester EPDS scores. Perinatal anxiety was not associated with WM structure.

CONCLUSIONS

These results suggest that prenatal and postnatal maternal psychological distress is associated with brain WM tract developmental alterations in a sex- and timing-dependent manner. Future studies including behavioral data are required to consolidate associative outcomes for these alterations.

Gestational age and socio-demographic factors associated with school performance at the age of 12 years, a population-based study

BACKGROUND

Gestational age is positively associated with cognitive development, but socio-demographic factors also influence school performance. Previous studies suggested possible interaction, putting children with low socio-economic status (SES) at increased risk of the negative effects of prematurity.

OBJECTIVES

To investigate the association between gestational age in weeks, socio-demographic characteristics, and school performance at the age of 12 years among children in regular primary education.

METHODS

Population-based cohort study among liveborn singletons (N = 860,332) born in the Netherlands in 1999-2006 at 25-42 weeks' gestation, with school performance from 2011 to 2019. Regression analyses were conducted investigating the association of gestational age and sociodemographic factors with school performance and possible interaction.

RESULTS

School performance increased with gestational age up to 40 weeks. This pattern was evident across socio-demographic strata. Children born at 25 weeks had -0.57 SD (95% confidence interval -0.79, -0.35) lower school performance z-scores and lower secondary school level compared to 40 weeks. Low maternal education, low maternal age, and non-European origin were strongly associated with lower school performance. Being born third or later and low socioeconomic status (SES) were also associated with lower school performance, but differences were smaller than among other factors. When born preterm, children from mothers with low education level, low or high age, low SES or children born third or later were at higher risk for lower school performance compared to children of mothers with intermediate education level, aged 25-29 years, with intermediate SES or first borns (evidence of interaction).

CONCLUSIONS

Higher gestational age is associated with better school performance at the age of 12 years along the entire spectrum of gestational age, beyond the cut-off of preterm birth and across socio-demographic differences. Children in socially or economically disadvantaged situations might be more vulnerable to the negative impact of preterm birth. Other important factors in school performance are maternal education, maternal age, ethnicity, birth order and SES. Results should be interpreted with caution due to differential loss to follow-up.

Intelligence Quotient (IQ) in school-aged preterm infants: A systematic review

Preterm birth (before 37 weeks of gestational age) is associated with certain risks to child development. The aim of this systematic review was to summarize available and updated empirical evidence on prematurity as a risk factor for cognitive development in school age. Thus, we attempted to identify similarities and differences with the full-term population and to point out possible risk or protective factors among the biological, psychosocial and family variables. The conceptualization and methodology of this review followed the PRISMA recommendations. The search was carried out in Web of Science, Scopus, PsycInfo, and Dialnet databases, in May 2022. The search was limited to journal articles, published between 2012 and 2022, in English and Spanish. Research articles selected were those focused on the intelligence quotient (IQ) of preterm children aged 6-12 years. The review included studies with cross-sectional or longitudinal cohorts, compared to a control group of children born at term or to standardized scales. The quality of evidence of the selected studies was verified with the Mixed Methods Appraisal Tool (MMAT). The initial search identified 1,040 articles. Forty articles met the inclusion criteria and were finally included in this review. These studies involved 5,396 preterm children from 37 different cohorts. Despite the diversity found among the results, in general, total IQ scores were within the normative mean for premature children; however, compared to their full-term peers, these scores were lower. The most studied variables in relation to IQ are perinatal (e.g., gestational age and birth weight) and family (e.g., socioeconomic level and education level of the mother). Recent studies corroborate that premature birth affects cognitive development in school age, and identify associated perinatal and family variables.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=337371; identifier: CRD42022337371.

Offspring school performance at age 12 after induction of labor vs non-intervention at term: A linked cohort study

INTRODUCTION

The incidence of induction of labor, for both medical reasons and as an elective procedure, has been rising and a further increase in induction of labor following the ARRIVE trial may be expected. The effects of induction of labor at term on childhood neurodevelopment, however, are not well studied. We aimed to study the influence of elective induction of labor for each week of gestation separately from 37 to 42 weeks on offspring school performance at 12 years of age after uncomplicated pregnancies.

MATERIAL AND METHODS

We performed a population-based study among 226 684 liveborn children from uncomplicated singleton pregnancies, born from 37⁺⁰ to 42⁺⁰  weeks of gestation in cephalic presentation in 2003-2008 (no hypertensive disorders, diabetes or birthweight ≤p5) in the Netherlands. Children with congenital anomalies, of non-white mothers and born after planned cesarean section were excluded. Birth records were linked with national data on school achievement. We compared, using a fetus-at-risk approach and per week of gestation, school performance score and secondary school level at age 12 in those born after induction of labor to those born after non-intervention, ie spontaneous onset of labor in the same week plus all those born at later gestations. Education scores were standardized to a mean of 0 and a standard deviation of 1 and adjusted in the regression analyses.

RESULTS

For each gestational age up to 41 weeks, induction of labor was associated with decreased school performance scores compared with non-intervention (at 37 weeks -0.05 SD, 95% confidence interval [CI] -0.10 to -0.01 SD; adjusted for confounding factors). After induction of labor, fewer children reached higher secondary school level (at 38 weeks 48% vs 54%; adjusted odds ratio [aOR] 0.88, 95% CI 0.82-0.94).

CONCLUSIONS

In women with uncomplicated pregnancies at term, consistently, at every week of gestation from 37 to 41 weeks, induction of labor is associated with lower offspring school performance at age 12 and lower secondary school level compared with non-intervention, although residual confounding may remain. These long-term effects of induction of labor should be incorporated in counseling and decision making.

Prenatal Stress and the Developing Brain: Postnatal Environments Promoting Resilience

Heightened maternal stress during pregnancy is associated with atypical brain development and an elevated risk for psychopathology in offspring. Supportive environments during early postnatal life may promote brain development and reverse atypical developmental trajectories induced by prenatal stress. We reviewed studies focused on the role of key early environmental factors in moderating associations between prenatal stress exposure and infant brain and neurocognitive outcomes. Specifically, we focused on the associations between parental caregiving quality, environmental enrichment, social support, and socioeconomic status with infant brain and neurocognitive outcomes. We examined the evidence that these factors may moderate the effects of prenatal stress on the developing brain. Complementing findings from translational models, human research suggests that high-quality early postnatal environments are associated with indices of infant neurodevelopment that have also been associated with prenatal stress, such as hippocampal volume and frontolimbic connectivity. Human studies also suggest that maternal sensitivity and higher socioeconomic status may attenuate the effects of prenatal stress on established neurocognitive and neuroendocrine mediators of risk for psychopathology, such as hypothalamic-pituitary-adrenal axis functioning. Biological pathways that may underlie the effects of positive early environments on the infant brain, including the epigenome, oxytocin, and inflammation, are also discussed. Future research in humans should examine resilience-promoting processes in relation to infant brain development using large sample sizes and longitudinal designs. The findings from this review could be incorporated into clinical models of risk and resilience during the perinatal period and used to design more effective early programs that reduce risk for psychopathology.

Direct and Indirect Effects of Social Support and School Social Capital on the Academic Success of 11–19-Year-Old Students Using Distance Learning

In the context of current changes in the education process due to the pandemic, the main aims of this study were to highlight social capital factors within the school community that are associated with better students’ outcomes in the context of distance learning. This study was a cross-sectional population-based study. The research sample consisted of 1483 students, whose ages varied from 11 to 19 years old (56.9% were girls). Academic success in this study was measured in terms of average grade and students’ perception of their learning process or outcomes by six single items. A Five-item WHO-5 questionnaire was used to measure students’ psychological well-being. Social capital was measured in terms of relationship, trust, reciprocity, and communication within different social contexts in the school community in total by 16 items. School social capital and social support scales were developed from these items. Students’ gender and age were also taken into consideration. The research results show that although social capital from parents and peers also matters, the relationship with teachers emerges as the main and the most important resource in supporting positive attitudes and outcomes in to learning (std.β varied from 0.116 to 0.439). The results also show that higher psychological wellbeing is associated with higher perceived school social capital (std.β 0.260) and social support (std.β 0.326) and mediates the effects of the latter two for better academic success outcomes. The findings also highlight the importance of close and trusting social ties, especially between students and their teachers as well as parents for better learning outcomes in times of crises and in the context of distance learning. The study results prove that social support and social capital at school are essential factors for sustainable psychological development. The results presumably support the idea that the school is sustainable if it is developing as an ecosystem not solely aimed at academic outcomes. The results of the current study may aid policymakers and practitioners in developing interventions, policies and practices that focus resources where they will have the greatest benefit.