Maternal education and cognitive development in 15 European very-preterm birth cohorts from the RECAP Preterm platform

Research output: Contribution to journalJournal articleResearchpeer-review

  • Mariane Sentenac
  • Valérie Benhammou
  • Ulrika Aden
  • Pierre Yves Ancel
  • Leonhard A. Bakker
  • Hannah Bakoy
  • Henrique Barros
  • Nicole Baumann
  • Klaus Børch
  • Ileana Croci
  • Marina Cuttini
  • Elizabeth Draper
  • Thomas Halvorsen
  • Samantha Johnson
  • Karin Källén
  • Tuuli Land
  • Jo Lebeer
  • Liisa Lehtonen
  • Rolf F. Maier
  • Neil Marlow
  • Andrei Morgan
  • Yanyan Ni
  • Katri Raikkonen
  • Anass Rtimi
  • Iemke Sarrechia
  • Heili Varendi
  • Maria Vollsaeter
  • Dieter Wolke
  • Milla Ylijoki
  • Jennifer Zeitlin

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.

Original languageEnglish
JournalInternational Journal of Epidemiology
Issue number6
Pages (from-to)1824-1839
Number of pages16
Publication statusPublished - 2022

Bibliographical note

Publisher Copyright:
© The Author(s) 2021; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

    Research areas

  • child development, cohort, intelligence, IQ, maternal education, Very-preterm births

ID: 291293592