32-36 Week Premies Have School Issues

Source: Peacock PJ, Henderson J, Odd D, et al. Early school attainment in late-preterm infants. Arch Dis Child. 2012;97(2):118-120; doi:10.1136/adc.2011.300925. See AAP Grand Rounds commentary by Dr. Gayle Haischer-Rollo (subscription required).

PICO
Question: Among a cohort of infants, do those who are born late-preterm (32-36 weeks) have worse school achievement than those born at term?
Question type: Descriptive
Study design: Retrospective cohort

This very brief (about 2 pages) article perhaps is a challenge to be less complacent about late-preterm infant developmental outcomes.  The investigators, from the United Kingdom, compared about 700 late-preterm infants to about 12,000 term infants in a retrospective fashion.  What is novel about this study is that the investigators looked at school performance when these children were ages 5-7 years, rather than focusing on earlier developmental outcomes reported by many other investigators.  After correcting for confounders such as gender, birth weight, multiple gestation preganancy, maternal education, and others, the late-preterm infants as a group scored lower on standardized assessments of reading, writing, and math. 

Statistical geeks among you might be interested in the authors' use of multiple imputation to correct for missing data; data were complete in only about 80% of children, and imputation allows one to fill in those data holes so that logistic regression analysis can be performed.  It sounds like cheating, making up data points where they don't exist, but in fact there is pretty strong statistical evidence to support this approach.  Even our own US Census Bureau uses similar techniques, because it's pretty hard to get people to open doors and provide data to census takers. 

Bottom line, pediatric health care providers should be on the lookout for school problems in late-preterm infants.