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 Researchers assessed kindergarten readiness at school age for 4,900
children born full-term and 950 late preterm infants, born up to
about three weeks early. The late preterm kids were 52 percent more
likely to be unprepared, the study found.
“At this point we cannot tell which babies will do the worst and may
need increased interventions prior to school entry, although our
study suggests that socioeconomic status plays a large role as well
as gestational age,” said lead study author Dr. Melissa Woythaler of
Massachusetts General Hospital in Boston.
Pregnancy normally lasts about 40 weeks, and babies born after 37
weeks are considered full term.
Roughly 75 percent of premature babies arrive between 34 and 37
weeks gestation, when they are considered late preterm, the
researchers note in the journal Pediatrics.
In the weeks immediately after birth, premature infants often have
difficulty breathing and digesting food. These early arrivals can
also encounter longer-term challenges such as impaired vision,
hearing, and cognitive skills as well as social and behavioral
problems.
Woythaler and colleagues quizzed a nationally representative sample
of five- and six-year-olds in age-appropriate skills associated with
success in reading, math, and expressive language. The kids born
late preterm had significantly lower scores in all three areas, and
had higher odds of severe impairment.
The premature babies in the study were less likely to be white, born
to college-educated or married mothers, or from families living
above the poverty level.
The children whose mental health assessments at age two indicated
significant or mild developmental delays were more likely to later
have kindergarten readiness scores in the bottom 5 percent.
Two-year-olds who had normal mental health scores or only mild
delays rarely scored in the bottom 5 percent on the kindergarten
readiness tests. About 92 percent of full term infants and 89
percent of late preterm babies with decent mental health scores
landed above the bottom 5 percent on kindergarten tests.
One shortcoming of the study is its focus on severe impairment,
which may overlook some children with school difficulties, the
researchers acknowledge.
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It’s also possible that some variables that contribute to late
preterm births also influence children’s performance on mental
health and school readiness tests, said Veronica Hinton, a neurology
researcher at Columbia University who wasn’t involved in the study.
“Given that multiple factors seem to contribute to falling in the
lower 5 percent on school readiness measures - including living in
an impoverished household, primary language other than English,
lower maternal education, and black maternal race, as well as late
preterm (birth) - it is reasonable to believe that the reasons why
some late preterm children are at risk are multi-factorial,” Hinton
said by email.
While the study found many children improved between age two and
kindergarten, it doesn’t clearly show why this may have happened or
whether certain children may have received extra care or support,
noted Dr. Margaret Kern of the University of Melbourne.
Parents of late preterm infants can do a lot to put development on
track for optimal kindergarten readiness, Kern, who wasn’t involved
in the study, said by email.
“Reading, playing games, and spending time with the infant are
helpful,” Kern said. “The early relationships to the primary
caregiver and others are important – don’t let iPads and technology
take your place.”
SOURCE: http://bit.ly/1DDhwRZ Pediatrics, online August 10, 2015.
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