Objective To estimate the impact on early development of prematurity and summer birth and the potential ‘double disadvantage’ created by starting school a year earlier than anticipated during pregnancy, due to being born preterm.
Design, setting and patients We investigated the impact of gestational and school-entry age on the likelihood of failing to achieve a ‘Good Level of Development’ (GLD) on the Early Years Foundation Stage Profile in 5-year-old children born moderate-to-late preterm using data from the Born in Bradford longitudinal birth cohort. We used hierarchical logistic regression to control for chronological maturity, and perinatal and socioeconomic factors.
Results Gestational age and school-entry age were significant predictors of attaining a GLD in the 10 337 children who entered school in the correct academic year given their estimated date of delivery. The odds of not attaining a GLD increased by 1.09 (95% CI 1.06 to 1.11) for each successive week born early and by 1.17 for each month younger within the year group (95% CI 1.16 to 1.18). There was no interaction between these two effects. Children starting school a year earlier than anticipated during pregnancy were less likely to achieve a GLD compared with (1) other children born preterm (fully adjusted OR 5.51 (2.85–14.25)); (2) term summer births (3.02 (1.49–6.79)); and (3) preterm summer births who remained within their anticipated school-entry year (3.64 (1.27–11.48)).
Conclusions These results confirm the developmental risks faced by children born moderate-to-late preterm, and—for the first time—illustrate the increased risk associated with ‘double disadvantage’.
- preterm birth
- child development
- born in Bradford
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Contributors ICMJE criteria for authorship read and met: KJP, BK, TAS, MM-W, JW, LJBH. Agree with the manuscript’s results and conclusions: KJP, BK, TAS, MM-W, JW, LJBH. Designed the study: KJP, TAS, LJBH. Analysed the data: LJBH, BK. Collected data/did experiments for the study: not applicable (secondary data analysis). Wrote the first draft of the paper: KJP. Contributed to the writing of the paper: KJP, BK, TAS, MM-W, JW, LJBH.
Funding BiB receives core infrastructure funding from the Wellcome Trust (WT101597MA) and the National Institute for Health Research (NIHR) under its Collaboration for Applied Health Research and Care (CLAHRC) for Yorkshire and Humber and Clinical Research Network (CRN) research delivery support. Linkages with education data for this cohort are further supported by a joint grant from the UK Medical Research Council and UK Economic and Social Science Research Council (MR/N024397/1) and through the Opportunity Areas programme in Bradford. The views expressed are those of the author(s), and not necessarily those of the NHS, the NIHR , the Department of Health and Social Care, the Bradford Opportunity Area Partnership Board, the City of Bradford Metropolitan District Council, or the Department of Education.
Disclaimer The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health and Social Care, the Bradford Opportunity Area Partnership Board, the City of Bradford Metropolitan District Council, or the Department of Education.
Competing interests None declared.
Ethics approval Ethics approval was obtained for the main platform study from the Bradford Research Ethics Committee (Ref 07/H1302/112).
Provenance and peer review Not commissioned; internally peer reviewed.
Data sharing statement All the data we have used are available on request from the BiB longitudinal cohort study. Access to this data is available on request via this link (https://borninbradford.nhs.uk/research/how-to-access-data/). We (the authors) do not have permission to republish independently the data shared with us by the cohort to conduct our study, as per the conditions of the data sharing agreement we signed with BiB in order to be granted access to their data.
Patient consent for publication Not required.