A1 Refereed original research article in a scientific journal
Maternal education and cognitive development in 15 European very-preterm birth cohorts from the RECAP Preterm platform
Authors: Sentenac Mariane, Benhammou Valérie, Aden Ulrika, Ancel Pierre-Yves, Bakker Leonhard A, Bakoy Hannah, Barros Henrique, Baumann Nicole, Bilsteen Josephine Funck, Boerch Klaus, Croci Ileana, Cuttini Marina, Draper Elizabeth, Halvorsen Thomas, Johnson Samantha, Källén Karin, Land Tuuli, Lebeer Jo, Lehtonen Liisa, Maier Rolf F, Marlow Neil, Morgan Andrei, Ni Yanyan, Raikkonen Katri, Rtimi Anass, Sarrechia Iemke, Varendi Heili, Vollsaeter Maria, Wolke Dieter, Ylijoki Milla, Zeitlin Jennifer
Publisher: Oxford University Press
Publication year: 2021
Journal: International Journal of Epidemiology
Journal name in source: INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
Journal acronym: INT J EPIDEMIOL
Volume: 50
Issue: 6
First page : 1824
Last page: 1839
Number of pages: 16
ISSN: 0300-5771
eISSN: 1464-3685
DOI: https://doi.org/10.1093/ije/dyab170
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.