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Archives of Disease in Childhood. Fetal and Neonatal Edition logoLink to Archives of Disease in Childhood. Fetal and Neonatal Edition
. 2001 Jul;85(1):F23–F28. doi: 10.1136/fn.85.1.F23

Educational and behavioural problems in babies of 32-35 weeks gestation

C Huddy, A Johnson, P Hope
PMCID: PMC1721280  PMID: 11420317

Abstract

AIM—To identify incidence of school and behaviour problems at age 7 years in children born between 32 and 35 weeks gestation, and investigate perinatal risk factors.
METHOD—The study population consisted of all children born at 32-35 weeks gestation to mothers resident in Oxfordshire in l990. General practitioners, parents, and teachers were asked about health, behaviour, and education by postal questionnaire. Teachers rated children on level of function in six areas using a five point scale. They also completed the Strengths and Difficulties behaviour questionnaire. Perinatal risk factors were identified for children with poor school performance using a univariate and multivariate analysis.
RESULTS—Teacher responses were obtained for 117 (66%) of the 176 children in the cohort. Twenty nine (25%) required support from a non-teaching assistant, five (4%) had required a statement of special educational needs, and three (3%) were at special school. Poor outcome was reported for 32% in writing, 31% in fine motor skills, 29% in mathematics, 19% in speaking, 21% in reading, and 12% in physical education. On the behaviour questionnaire, 19% of the cohort achieved an abnormal hyperactivity score (population norm 10%). Multivariate analysis showed perinatal variables that remained significant, independent of other variables; they were discharge from the special care baby unit > 36 weeks postconceptional age (odds ratio 4.15; 95% confidence interval 1.43 to 12.05) and male sex (odds ratio 3.88; 95% confidence interval 1.42 to 10.6).
CONCLUSION—Up to a third of children born between 32 and 35 weeks gestation may have school problems. As there are larger numbers in this gestational category compared with smaller babies, this finding has implications for educational services.



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Selected References

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  1. Alderdice F., Petty T., Johnson A., Macfarlane A. The feasibility of using a postal survey method to assess the health and development of 7 year old children of different birth weight. J Epidemiol Community Health. 1998 Jul;52(7):439–444. doi: 10.1136/jech.52.7.439. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Aylward G. P., Pfeiffer S. I., Wright A., Verhulst S. J. Outcome studies of low birth weight infants published in the last decade: a metaanalysis. J Pediatr. 1989 Oct;115(4):515–520. doi: 10.1016/s0022-3476(89)80273-2. [DOI] [PubMed] [Google Scholar]
  3. Francis-Williams J., Davies P. A. Very low birthweight and later intelligence. Dev Med Child Neurol. 1974 Dec;16(6):709–728. doi: 10.1111/j.1469-8749.1974.tb03392.x. [DOI] [PubMed] [Google Scholar]
  4. Goodman R. The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry. 1997 Jul;38(5):581–586. doi: 10.1111/j.1469-7610.1997.tb01545.x. [DOI] [PubMed] [Google Scholar]
  5. Hille E. T., den Ouden A. L., Bauer L., van den Oudenrijn C., Brand R., Verloove-Vanhorick S. P. School performance at nine years of age in very premature and very low birth weight infants: perinatal risk factors and predictors at five years of age. Collaborative Project on Preterm and Small for Gestational Age (POPS) Infants in The Netherlands. J Pediatr. 1994 Sep;125(3):426–434. doi: 10.1016/s0022-3476(05)83290-1. [DOI] [PubMed] [Google Scholar]
  6. Horwood L. J., Mogridge N., Darlow B. A. Cognitive, educational, and behavioural outcomes at 7 to 8 years in a national very low birthweight cohort. Arch Dis Child Fetal Neonatal Ed. 1998 Jul;79(1):F12–F20. doi: 10.1136/fn.79.1.f12. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Johnson A., Townshend P., Yudkin P., Bull D., Wilkinson A. R. Functional abilities at age 4 years of children born before 29 weeks of gestation. BMJ. 1993 Jun 26;306(6894):1715–1718. doi: 10.1136/bmj.306.6894.1715. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Kempley S. T., Diffley F. S., Ruiz G., Lowe D., Evans B. G., Gamsu H. R. Birth weight and special educational needs: effects of an increase in the survival of very low birthweight infants in London. J Epidemiol Community Health. 1995 Feb;49(1):33–37. doi: 10.1136/jech.49.1.33. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Klebanov P. K., Brooks-Gunn J., McCormick M. C. Classroom behavior of very low birth weight elementary school children. Pediatrics. 1994 Nov;94(5):700–708. [PubMed] [Google Scholar]
  10. Lagercrantz H. Better born too soon than too small. Lancet. 1997 Oct 11;350(9084):1044–1045. doi: 10.1016/S0140-6736(05)70450-5. [DOI] [PubMed] [Google Scholar]
  11. Leonard C. H., Piecuch R. E., Ballard R. A., Cooper B. A. Outcome of very low birth weight infants: multiple gestation versus singletons. Pediatrics. 1994 Apr;93(4):611–615. [PubMed] [Google Scholar]
  12. Marlow N., Hunt L. P., Chiswick M. L. Clinical factors associated with adverse outcome for babies weighing 2000 g or less at birth. Arch Dis Child. 1988 Oct;63(10 Spec No):1131–1136. doi: 10.1136/adc.63.10_spec_no.1131. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Marlow N., Roberts B. L., Cooke R. W. Motor skills in extremely low birthweight children at the age of 6 years. Arch Dis Child. 1989 Jun;64(6):839–847. doi: 10.1136/adc.64.6.839. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Marlow N., Roberts L., Cooke R. Outcome at 8 years for children with birth weights of 1250 g or less. Arch Dis Child. 1993 Mar;68(3 Spec No):286–290. doi: 10.1136/adc.68.3_spec_no.286. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Martin E., Barkovich A. J. Magnetic resonance imaging in perinatal asphyxia. Arch Dis Child Fetal Neonatal Ed. 1995 Jan;72(1):F62–F70. doi: 10.1136/fn.72.1.f62. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. McCormick M. C., Gortmaker S. L., Sobol A. M. Very low birth weight children: behavior problems and school difficulty in a national sample. J Pediatr. 1990 Nov;117(5):687–693. doi: 10.1016/s0022-3476(05)83322-0. [DOI] [PubMed] [Google Scholar]
  17. Middle C., Johnson A., Alderdice F., Petty T., Macfarlane A. Birthweight and health and development at the age of 7 years. Child Care Health Dev. 1996 Jan;22(1):55–71. [PubMed] [Google Scholar]
  18. Murphy D. J., Hope P. L., Johnson A. Neonatal risk factors for cerebral palsy in very preterm babies: case-control study. BMJ. 1997 Feb 8;314(7078):404–408. doi: 10.1136/bmj.314.7078.404. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Ornstein M., Ohlsson A., Edmonds J., Asztalos E. Neonatal follow-up of very low birthweight/extremely low birthweight infants to school age: a critical overview. Acta Paediatr Scand. 1991 Aug-Sep;80(8-9):741–748. doi: 10.1111/j.1651-2227.1991.tb11943.x. [DOI] [PubMed] [Google Scholar]
  20. Pena I. C., Teberg A. J., Finello K. M. The premature small-for-gestational-age infant during the first year of life: comparison by birth weight and gestational age. J Pediatr. 1988 Dec;113(6):1066–1073. doi: 10.1016/s0022-3476(88)80584-5. [DOI] [PubMed] [Google Scholar]
  21. Pharoah P. O., Stevenson C. J., Cooke R. W., Stevenson R. C. Clinical and subclinical deficits at 8 years in a geographically defined cohort of low birthweight infants. Arch Dis Child. 1994 Apr;70(4):264–270. doi: 10.1136/adc.70.4.264. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Pharoah P. O., Stevenson C. J., Cooke R. W., Stevenson R. C. Prevalence of behaviour disorders in low birthweight infants. Arch Dis Child. 1994 Apr;70(4):271–274. doi: 10.1136/adc.70.4.271. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Rantakallio P., von Wendt L. Prognosis for low-birthweight infants up to the age of 14: a population study. Dev Med Child Neurol. 1985 Oct;27(5):655–663. doi: 10.1111/j.1469-8749.1985.tb14138.x. [DOI] [PubMed] [Google Scholar]
  24. Robertson C. M., Etches P. C., Kyle J. M. Eight-year school performance and growth of preterm, small for gestational age infants: a comparative study with subjects matched for birth weight or for gestational age. J Pediatr. 1990 Jan;116(1):19–26. doi: 10.1016/s0022-3476(05)81639-7. [DOI] [PubMed] [Google Scholar]
  25. Saigal S., Szatmari P., Rosenbaum P., Campbell D., King S. Cognitive abilities and school performance of extremely low birth weight children and matched term control children at age 8 years: a regional study. J Pediatr. 1991 May;118(5):751–760. doi: 10.1016/s0022-3476(05)80043-5. [DOI] [PubMed] [Google Scholar]
  26. Sung I. K., Vohr B., Oh W. Growth and neurodevelopmental outcome of very low birth weight infants with intrauterine growth retardation: comparison with control subjects matched by birth weight and gestational age. J Pediatr. 1993 Oct;123(4):618–624. doi: 10.1016/s0022-3476(05)80965-5. [DOI] [PubMed] [Google Scholar]
  27. Sutton L., Bajuk B., Duffy B., Alexander I., Arnold J., Leslie G., Henderson-Smart D., John E., Roberts V., Berry A. Short-term outcome of mechanically ventilated infants weighing more than 2499 g at birth: a population based study. J Paediatr Child Health. 1993 Dec;29(6):418–423. doi: 10.1111/j.1440-1754.1993.tb03012.x. [DOI] [PubMed] [Google Scholar]
  28. Wariyar U. K., Richmond S. Morbidity and preterm delivery: importance of 100% follow-up. Lancet. 1989 Feb 18;1(8634):387–388. doi: 10.1016/s0140-6736(89)91764-9. [DOI] [PubMed] [Google Scholar]
  29. Wolke D. Psychological development of prematurely born children. Arch Dis Child. 1998 Jun;78(6):567–570. doi: 10.1136/adc.78.6.567. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Wolke D., Söhne B., Ohrt B., Riegel K. Follow-up of preterm children: important to document dropouts. Lancet. 1995 Feb 18;345(8947):447–447. doi: 10.1016/s0140-6736(95)90425-5. [DOI] [PubMed] [Google Scholar]
  31. Yu V. Y., Downe L., Astbury J., Bajuk B. Perinatal factors and adverse outcome in extremely low birthweight infants. Arch Dis Child. 1986 Jun;61(6):554–558. doi: 10.1136/adc.61.6.554. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Zinkin P. M., Cox C. A. Child health clincs and inverse care laws: evidence from longitudinal study of 1878 pre-school children. Br Med J. 1976 Aug 14;2(6032):411–413. doi: 10.1136/bmj.2.6032.411. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Zubrick S. R., Macartney H., Stanley F. J. Hidden handicap in school-age children who received neonatal intensive care. Dev Med Child Neurol. 1988 Apr;30(2):145–152. doi: 10.1111/j.1469-8749.1988.tb04745.x. [DOI] [PubMed] [Google Scholar]

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