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 In the analysis of 228,030 singleton births in Denmark, infants who
were born after only 38 weeks of pregnancy were 15 percent less
likely than those born at 40 weeks to have some education beyond
high school or to be among the top earners in the study.
"While adults born at 35 to 38 weeks of gestation experienced only
slightly lower chances of high income and a high educational level,
this may have a significant impact since a large proportion
(approximately 10 percent) of all children are born in these weeks,"
said lead study author Josephine Funck Bilsteen of the University of
Copenhagen and Hvidovre University Hospital in Denmark.
Pregnancy normally lasts about 40 weeks, and babies born after 37
weeks of gestation are considered full-term. Babies born prematurely
- earlier than 37 weeks - often have difficulty breathing and
digesting food in the weeks immediately following birth. These
preemies can also encounter longer-term challenges such as impaired
vision, hearing and cognitive skills, as well as social and
behavioral problems.
"Previous research has shown that adults born preterm are more
likely to have a lower educational level and lower income than
adults born term," Bilsteen said by email. "However, much less is
known about differences in education and income among adults born at
different gestational weeks within the term period."
To examine this question, researchers looked at data for babies born
in Denmark between 1982 and 1986.
As expected, the earliest preemies fared the worst. Compared with
infants born at 40 weeks, babies who arrived at just 22 to 27 weeks
gestation were 79 percent less likely to have any education beyond
high school and 34 percent less likely to be among the top wage
earners in the study, researchers report in JAMA Network Open.
Just one week might make a difference. Babies born at 39 weeks were
still slightly less likely to succeed academically or financially
than infants who arrived at 40 weeks.
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These estimates accounted for other factors that can independently
impact both gestational age and adult achievement including sex and
birth year as well as mothers' age, education levels and country of
origin.
The study wasn't designed to prove whether or how gestational age
might directly impact educational or economic outcomes in adulthood,
however. It's possible, for example, that gestational age reflects
some other individual or family factor that also influences
socioeconomic outcomes.
One limitation of the study is the potential for gestational age to
be inaccurate for some babies since doctors can use different
methods to estimate when a baby was conceived and might misclassify
infants in some cases, the study authors note.
"I'd suggest that parents take these findings with a grain of salt,"
said Margaret Kern, a researcher at the University of Melbourne in
Australia who wasn't involved in the study.
"Early birth does not doom a child to failure in the world if that
is defined as economic success, which I'd question," Kern said by
email. One in five babies arrive early and many of them do well in
adulthood, she added, "so clearly there are a lot of success cases
there to draw on."
While parents can't control when babies arrive, they should keep the
potential for negative outcomes in mind when scheduling an elective
cesarean section delivery, said Dieter Wolke, a researcher at the
University of Warwick in the UK who wasn't involved in the study.
Babies that come early, even on the early end of what's considered
full-term, may be more shy or withdrawn and struggle with attention
and participation in school, Wolke said by email.
SOURCE: https://bit.ly/2H4E0D3 JAMA Network Open, online December
14, 2018.
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