Abstract
The effect of socio-economic status (SES) on the cognitive outcome of preterm-born children is unknown. The objectives of this study were to systematically review the published literature and to report the strength and consistency of the effect of SES on the cognitive outcomes of preterm children, across different SES indicators. We conducted a literature search on MEDLINE, EMBASE, PsycINFO and Social Science Citation Index to identify English-language cohort or case–control studies published after 1990 that had reported the effect of at least one SES indicator on cognitive outcome in children born <37 weeks gestation. Fifteen studies (from a total 4,162 identified) were included. Thirteen SES indicators were evaluated [categorized as: “individual-level” (6 indicators), “family-structure” (3), “contextual” (2) and “composite” (2)]. Maternal educational level was the most frequently evaluated SES indicator (by 11/15 studies) and was most consistently associated with cognitive outcome. Maternal education below high school level was associated with severe cognitive deficiency [reported odds ratios (95 % CI) range: OR = 1.4 (1.0–1.9) to OR = 2.3 (1.2–4.5)]. A meta-analytic measure of the effect of SES was not calculated due to heterogeneity in studies. SES appears to confound the association between preterm birth and cognitive deficit and should be adjusted for in studies reporting cognitive outcome.
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Saigal, S., den Ouden, L., Wolke, D., Hoult, L., Paneth, N., Streiner, D. L., et al. (2003). School-age outcomes in children who were extremely low birth weight from four international population-based cohorts. Pediatrics, 112(4), 943–950.
Aylward, G. P. (2005). Neurodevelopmental outcomes of infants born prematurely. Journal of Developmental and Behavioral Pediatrics, 26(6), 427–440.
Bhutta, A. T., Cleves, M. A., Casey, P. H., Cradock, M. M., & Anand, K. J. (2002). Cognitive and behavioral outcomes of school-aged children who were born preterm: a meta-analysis. Journal of the American Medical Association, 288(6), 728–737.
Johnson, S. (2007). Cognitive and behavioural outcomes following very preterm birth. Seminars in Fetal and Neonatal Medicine, 12(5), 363–373.
Marlow, N. (2004). Neurocognitive outcome after very preterm birth. Archives of Disease Childhood Fetal & Neonatal Edition, 89(3), F224–F228.
Saigal, S., & Doyle, L. W. (2008). An overview of mortality and sequelae of preterm birth from infancy to adulthood. Lancet, 371(9608), 261–269.
Feinstein, L. (2003). Inequality in the early cognitive development of children in the 1970 cohort. Economica, 70(277), 73–97.
Blumenshine, P., Egerter, S., Barclay, C. J., Cubbin, C., & Braveman, P. A. (2010). Socioeconomic disparities in adverse birth outcomes: a systematic review. American Journal of Preventive Medicine, 39(3), 263–272.
Escalona, S. K. (1982). Babies at double hazard: early development of infants at biologic and social risk. Pediatrics, 70(5), 670–676.
Parker, S., Greer, S., & Zuckerman, B. (1988). Double jeopardy: the impact of poverty on early child development. Pediatric Clinics of North America, 35(6), 1227–1240.
Ekeus, C., Lindstrom, K., Lindblad, F., Rasmussen, F., & Hjern, A. (2010). Preterm birth, social disadvantage, and cognitive competence in Swedish 18- to 19-year-old men. Pediatrics, 125(1), e67–e73.
Weisglas-Kuperus, N., Hille, E. T., Duivenvoorden, H. J., Finken, M. J., Wit, J. M., van Buuren, S., et al. (2009). Intelligence of very preterm or very low birthweight infants in young adulthood. Archives of Disease in Childhood. Fetal and Neonatal Edition, 94(3), F196–F200.
Bacharach, V. R., & Baumeister, A. A. (1998). Effects of maternal intelligence, marital status, income, and home environment on cognitive development of low birthweight infants. Journal of Pediatric Psychology, 23(3), 197–205.
Chaudhari, S., Otiv, M., Chitale, A., Hoge, M., Pandit, A., & Mote, A. (2005). Biology versus environment in low birth weight children. Indian Pediatrics, 42(8), 763–770.
Levy-Shiff, R., Einat, G., Mogilner, M. B., Lerman, M., & Krikler, R. (1994). Biological and environmental correlates of developmental outcome of prematurely born infants in early adolescence. Journal of Pediatric Psychology, 19(1), 63–78.
Baron, I. S., & Rey-Casserly, C. (2010). Extremely preterm birth outcome: a review of four decades of cognitive research. Neuropsychology Review, 20(4), 430–452.
Hillemeier, M. M., Farkas, G., Morgan, P. L., Martin, M. A., & Maczuga, S. A. (2009). Disparities in the prevalence of cognitive delay: how early do they appear? Paediatric and Perinatal Epidemiology, 23(3), 186–198.
Armstrong, R., Waters, E., Jackson, N., Oliver, S., Popay, J., Shepherd, J., et al. (2007). Guidelines for systematic reviews of health promotion and public health interventions. Version 2. Australia: Melbourne University. Available at http://ph.cochrane.org/sites/ph.cochrane.org/files/uploads/Guidelines%20HP_PH%20reviews.pdf.
Stroup, D. F., Berlin, J. A., Morton, S. C., Olkin, I., Williamson, G. D., Rennie, D., et al. (2000). Meta-analysis of observational studies in epidemiology: A proposal for reporting. Meta-analysis Of Observational Studies in Epidemiology (MOOSE) group. Journal of the American Medical Association, 283(15), 2008–2012.
Effective Public Health Practice Project. (2002). Quality assessment tool for quantitative studies. Hamilton, Ontario, Canada: McMaster University. Available at http://www.ephpp.ca/pdf/qatool.pdf.
Beaino, G., Khoshnood, B., Kaminski, M., Marret, S., Pierrat, V., Vieux, R., et al. (2011). Predictors of the risk of cognitive deficiency in very preterm infants: The EPIPAGE prospective cohort. Acta Paediatrica, 100(3), 370–378.
Bruggink, J. L., Van Braeckel, K. N., & Bos, A. F. (2010). The early motor repertoire of children born preterm is associated with intelligence at school age. Pediatrics, 125(6), e1356–e1363.
Chen, P. S., Jeng, S. F., & Tsou, K. I. (2004). Developmental function of very-low-birth-weight infants and full-term infants in early childhood. Journal of the Formosan Medical Association, 103(1), 23–31.
Dall’oglio, A. M., Rossiello, B., Coletti, M. F., Bultrini, M., De Marchis, C., Rava, L., et al. (2010). Do healthy preterm children need neuropsychological follow-up? Preschool outcomes compared with term peers. Developmental Medicine & Child Neurology, 52(10), 955–961.
Dezoete, J. A., MacArthur, B. A., & Tuck, B. (2003). Prediction of Bayley and Stanford-Binet scores with a group of very low birthweight children. Child: Care, Health & Development, 29(5), 367–372.
Hack, M., Wilson-Costello, D., Friedman, H., Taylor, G. H., Schluchter, M., & Fanaroff, A. A. (2000). Neurodevelopment and predictors of outcomes of children with birth weights of less than 1000 g: 1992–1995. Archives of Pediatrics and Adolescent Medicine, 154(7), 725–731.
Johnson, S., Wolke, D., Hennessy, E., & Marlow, N. (2011). Educational outcomes in extremely preterm children: Neuropsychological correlates and predictors of attainment. Developmental Neuropsychology, 36(1), 74–95.
Laptook, A. R., O’Shea, T. M., Shankaran, S., & Bhaskar, B. (2005). Adverse neurodevelopmental outcomes among extremely low birth weight infants with a normal head ultrasound: prevalence and antecedents. Pediatrics, 115(3), 673–680.
Lowe, J., Erickson, S. J., & MacLean, P. (2010). Cognitive correlates in toddlers born very low birth weight and full-term. Infant Behaviour and Development, 33(4), 629–634.
Piecuch, R. E., Leonard, C. H., Cooper, B. A., Kilpatrick, S. J., Schlueter, M. A., & Sola, A. (1997). Outcome of infants born at 24–26 weeks’ gestation: II. Neurodevelopmental outcome. Obstetrics & Gynecology, 90(5), 809–814.
Potharst, E. S., van Wassenaer, A. G., Houtzager, B. A., van Hus, J. W., Last, B. F., & Kok, J. H. (2011). High incidence of multi-domain disabilities in very preterm children at five years of age. Journal of Pediatrics, 159(1), 79–85.
Stoelhorst, G. M. S. J., Rijken, M., Martens, S. E., Van Zwieten, P. H. T., Feenstra, J., Zwinderman, A. H., et al. (2003). Developmental outcome at 18 and 24 months of age in very preterm children: A cohort study from 1996 to 1997. Early Human Development, 72(2), 83–95.
Vohr, B. R., Wright, L. L., Dusick, A. M., Perritt, R., Poole, W. K., Tyson, J. E., et al. (2004). Center differences and outcomes of extremely low birth weight infants. Pediatrics, 113(4), 781–789.
Hack, M., Taylor, H. G., Drotar, D., Schluchter, M., Cartar, L., Wilson-Costello, D., et al. (2005). Poor predictive validity of the Bayley Scales of Infant Development for cognitive function of extremely low birth weight children at school age. Pediatrics, 116(2), 333–341.
Wang, L. W., Wang, S. T., & Huang, C. C. (2008). Preterm infants of educated mothers have better outcome. Acta Paediatrica, 97(5), 568–573.
Callanan, C., Doyle, L., Rickards, A., Kelly, E., Ford, G., & Davis, N. (2001). Children followed with difficulty: How do they differ? Journal of Paediatrics and Child Health, 37(2), 152–156.
Hille, E. T., Elbertse, L., Gravenhorst, J. B., Brand, R., & Verloove-Vanhorick, S. P. (2005). Nonresponse bias in a follow-up study of 19-year-old adolescents born as preterm infants. Pediatrics, 116(5), e662–e666.
Tin, W., Fritz, S., Wariyar, U., & Hey, E. (1998). Outcome of very preterm birth: children reviewed with ease at 2 years differ from those followed up with difficulty. Archives of Disease in Childhood Fetal & Neonatal Edition, 79(2), F83–F87.
Shavers, V. L. (2007). Measurement of socioeconomic status in health disparities research. Journal of the National Medical Association, 99(9), 1013–1023.
Bendersky, M., & Lewis, M. (1994). Environmental risk, biological risk, and developmental outcome. Developmental Psychology, 30(4), 484–494.
Hack, M., Breslau, N., Aram, D., Weissman, B., Klein, N., & Borawski-Clark, E. (1992). The effect of very low birth weight and social risk on neurocognitive abilities at school age. Journal of Developmental and Behavioral Pediatrics, 13(6), 412–420.
Fawer, C. L., Besnier, S., Forcada, M., Buclin, T., & Calame, A. (1995). Influence of perinatal, developmental and environmental factors on cognitive abilities of preterm children without major impairments at 5 years. Early Human Development, 43(2), 151–164.
Weisglas-Kuperus, N., Baerts, W., Smrkovsky, M., & Sauer, P. J. (1993). Effects of biological and social factors on the cognitive development of very low birth weight children. Pediatrics, 92(5), 658–665.
March of Dimes, The Partnership for Maternal, Neonatal & Child Health, Save the Children, & World Health Organization. (2012). In C. P. Howson, M. V. Kinney, & Lawn, J. E. (Ed.), Born too soon: The global action report on preterm births. Geneva: World Health Organization. Available at http://www.who.int/pmnch/media/news/2012/201204_borntoosoon-report.pdf.
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Wong, H.S., Edwards, P. Nature or Nurture: A Systematic Review of the Effect of Socio-economic Status on the Developmental and Cognitive Outcomes of Children Born Preterm. Matern Child Health J 17, 1689–1700 (2013). https://doi.org/10.1007/s10995-012-1183-8
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DOI: https://doi.org/10.1007/s10995-012-1183-8