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Maternal education and cognitive development in 15 European very preterm birth cohorts from the RECAP Preterm platform

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posted on 2021-08-17, 09:02 authored by Mariane Sentenac, Valerie Benhammou, Ulrika Aden, Pierre-Yves Anccel, Leonhard A Bakker, Hannah Bakoy, Henrique Barros, Nicole Baumann, Josephine Funck Bilsteen, Klaus Boerch, Ileana Croci, Marina Cuttini, Elizabeth Draper, Thomas Halvorsen, Samantha Johnson, Karin Kallen, Tuuli Land, Jo Lebeer, Liisa Lehtonen, Rolf F Maier, Neil Marlow, Andrei Morgan, Yanyan Ni, Katri Raikkonen, Anass Rtimi, Iemke Sarrechia, Heili Varendi, Maria Vollsaeter, Dieter Wolke, Milla Ylijoki, Jennifer Zeitlin

Background

Studies are sparse and inconclusive about the association between maternal education and cognitive development among children born very preterm (VPT). Although this association is well established in the general population, questions remain about its magnitude among children born VPT whose risks of medical and developmental complications are high. We investigated the association of maternal education with cognitive outcomes in European VPT birth cohorts.


Methods

We used harmonized aggregated data from 15 population-based cohorts of children born at <32 weeks of gestational age (GA) or <1500 g from 1985 to 2013 in 13 countries with information on maternal education and assessments of general development at 2–3 years and/or intelligence quotients between 4 and 15 years. Term-born controls (≥37 weeks of GA) were available in eight cohorts. Maternal education was classified as: low (primary/lower secondary); medium (upper secondary/short tertiary); high (bachelor’s/higher). Pooled standardized mean differences (SMDs) in cognitive scores were estimated (reference: high educational level) for children assessed at ages 2–3, 4–7 and 8–15 years.


Results

The study included 10 145 VPT children from 12 cohorts at 2–3 years, 8829 from 12 cohorts at 4–7 years and 1865 children from 6 cohorts at 8–15 years. Children whose mothers had low, compared with high, educational attainment scored lower on cognitive measures [pooled unadjusted SMDs: 2–3 years = −0.32 (95% confidence intervals: −0.43 to −0.21); 4–7 years = −0.57 (−0.67; −0.47); 8–15 years = −0.54 (−0.72; −0.37)]. Analyses by GA subgroups (<27 vs ≥27 weeks) in children without severe neonatal morbidity and term controls yielded similar results.


Conclusions

Across diverse settings and regardless of the degree of prematurity, low maternal education was associated with lower cognition.

Funding

RECAP preterm: Research on European Children and Adults born Preterm

European Commission

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History

Author affiliation

Department of Health Sciences, University of Leicester

Version

  • AM (Accepted Manuscript)

Published in

International Journal of Epidemiology

Volume

50

Issue

6

Pagination

1824-1839

Publisher

Oxford University Press (OUP)

issn

0300-5771

Acceptance date

2021-07-16

Copyright date

2021

Available date

2022-09-22

Language

en

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