Long-Term Educational Outcomes of Individuals Born Preterm
Bibliographic record
Abstract
Importance: Children born preterm may face neurodevelopmental challenges. Data on how this translates into long-term educational outcomes at the population level are scarce. Objective: To quantify relative contributions of preterm birth and sociodemographic factors to educational achievement and attainment. Design, Setting, and Participants: This case-control study included a birth cohort of all infants born preterm in Quebec, Canada, between 1976 and 1995, matched 1:2 with infants born term. Births before 37 weeks' gestations were considered preterm. The control cohort born between 37 and 42 weeks' gestation were matched by birth year, sex, and pregnancy type (singleton, twins). Administrative database linkages provided objective data for longitudinal follow-up to age 43 years. Individuals who died in 1976 to 2019 or without Quebec Ministry of Education records were excluded. Analyses were performed from February 2, 2023, to June 4, 2025. Exposure: Preterm birth, defined as extremely preterm (under 28 weeks), very preterm (28 to <32 weeks), or moderate-to-late preterm (32 to <37 weeks). Main Outcomes and Measures: Outcomes included high school performance (final high school average), high school graduation by age 22 years, and university degree at any age. Sociodemographic factors were extracted from the Quebec Births and Deaths registry. Socioeconomic status was derived using postal code and the Material and Social Deprivation Index. Results: Of 297 820 participants (160 980 male [54.0%]; 28 040 individuals [9.4%] born to mothers born outside Canada), 1915 (0.6%) were born extremely preterm, 13 225 (4.4%) very preterm, 83 105 (27.9%) moderate-to-late preterm, and 199 575 (67.0%) full term. Associations of preterm birth and final high school average were negligible among those who remained in school. Gestational age was associated with educational attainment in a dose-response pattern wherein individuals born extremely preterm were the most at risk for not graduating high school (OR, 1.80; 99% CI, 1.54-2.09) or not obtaining a university degree (OR, 1.68; 99% CI, 1.39-2.02). The contribution of preterm birth was small compared with male sex, maternal educational level, socioeconomic status, and migration related factors. Conclusions and Relevance: In this case-control study, individuals born preterm were more likely than full-term counterparts to not complete high school, yet sociodemographic factors were more important than preterm status for educational attainment. Our findings substantiate the need for long-term follow-up and support to children born preterm and their families.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".