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Preterm birth, poverty independently associated with cognitive assessment deficits
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Although preterm birth and household poverty were each independent predictors of cognitive scores in children, the two factors were independent of each other, according to published study results in Pediatrics.
“We know from prior evidence that children born preterm have lower scores on cognitive tests than their term-born counterparts,” Jennifer I. Beauregard, MPH, PhD, of the department of epidemiology, Rollins School of Public Health, Emory University, Atlanta, told Infectious Diseases in Children. “We also know that children living in poverty have lower scores than wealthier children. What we don’t know is whether children who are both born preterm and raised in poverty simply experience the sum of the two effects, or whether there is some synergy or interaction between the two factors such that risk is higher or lower than expected.”
Beauregard and colleagues analyzed data on about10,000 children enrolled in the Millennium Cohort Study, a longitudinal study of children born in the United Kingdom in 2001-2002. Data on gestational age and household poverty status (defined as being below 60% of the median U.K. income) were collected from parents during home interviews when the children were 9 months old. Cognitive outcomes were measured at ages 3, 5 and 7 years old. Data on singletons born at 24 to 40 weeks’ gestation who were enrolled in the Millennium Cohort Study were used.
Linear regression models were used to estimate the mutually adjusted independent associations of preterm birth and household poverty with cognitive scores. Interaction terms were added to the models to test for the presence of interaction between the two factors.
Cognitive assessment scores tended to be lower for children born preterm at less than 37 weeks or early term from 37 to 38 weeks, compared with children born at term of 39 or 40 weeks.
When compared with term infants, for early or moderate preterm infants, deficits were estimated at about 0.2 to 0.3 SD. Estimated deficits were 0.1 SD for later preterm infants and 0.05 SD for early term infants when compared with term infants.
Compared with children not living in poverty, children living in poverty had scores of 0.3 to 0.4 SD worse.
Interaction between gestational age and poverty was not evident in most measurements.
“We found that preterm birth and household poverty were each independent and important predictors of cognitive scores,” Beauregard said. “There was no evidence to suggest that the two factors interacted to put children who were exposed to both factors at higher or lower than expected risk; these children experienced the sum of the two effects. While living in poverty did not magnify the adverse effect of preterm birth on cognitive outcomes, children exposed to both factors had the lowest cognitive scores.” – Bruce Thiel
Disclosures: The authors report no relevant financial disclosures.
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