The effect of late preterm birth on education, executive function and graphomotor skills

The influence of prematurity has been shown to include worse neurodevelopmental outcomes, when compared to outcomes in children born at full term. However, there are far fewer studies considering the effects of late preterm birth (34 to 36 weeks’ gestation), the largest preterm group, and the effects are therefore less certain. The aim of this thesis is to investigate the impact of late preterm birth on educational, executive function, and graphomotor outcomes.
Chapter Three of this thesis investigates if children born late preterm have increased odds of not reaching expected standards in overall educational achievement at ages 5, 7, and 11 years. It finds increased odds of not reaching expected levels present to age 7 in the covariate-adjusted model, and to age 11 in the unadjusted model. Chapter Four examines the trajectory of educational scores in primary education for children born late preterm, compared to children born at full term. It finds no evidence of educational “catch up” in children born late preterm. Chapter Five looks at executive function (working memory and inhibition), finding children born late preterm have poorer complex working memory than children born full term. Chapter Six examines differences in graphomotor outcomes using kinematic assessment in children born late preterm compared to full term, at age 4-5 and 7-10 years. The results suggest that children born late preterm have worse graphomotor “tracking skills” than children born full term.
This thesis contributes to the sparse literature examining outcomes for children born LPT in childhood, finding worse educational achievement; no longitudinal evidence of educational catching up; poorer complex working memory and graphomotor tracking skills, but these were consistently small effects. There is potential to follow up children born LPT using health and educational data tracking. Furthermore, greater teacher awareness of the impact of prematurity would help support such children.