ArticlePloS one2024
Association between preterm birth and economic and educational outcomes in adulthood: A population-based matched cohort study.
Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Socioeconomic outcomes in very preterm/very low birth weight adults: individual participant data meta-analysis.Pediatric research · 2025Pooled it
- Global and population-specific association of MTHFR polymorphisms with preterm birth risk: a consolidated analysis of 44 studies.BMC pregnancy and childbirth · 2025Pooled it
- Neonatal Brain Structure, Early Life Context, and Academic Achievement among Children Born Very Preterm.Journal of pediatrics. Clinical practice · 2026Article
- Gestational Age and Childhood Educational Outcomes in Primary and High School Years.JAMA network open · 2026Article
- Exploring the Early-Life Microbiomes of Preterm Infants and Their Childhood Health Outcomes (The BLOOM Study): Protocol for a Prospective, Observational Cohort Study.JMIR research protocols · 2026Article
- Early development and school readiness in very preterm children.Frontiers in pediatrics · 2026Article
- Evaluation of special educational needs and disability provision in English primary schools using administrative health and education data in the ECHILD database.International journal of population data science · 2026Article
- Effect of gestational age on special education: a population-based matched cohort analysis.Archives of disease in childhood. Fetal and neonatal edition · 2025Article
- Prematurity and Low Birth Weight Among Food-Secure and Food-Insecure Households: A Comparative Study in Surabaya, Indonesia.Nutrients · 2025Article
- Wealth Among Adults Aged 26 to 34 Years Born Very Preterm and Full Term.JAMA network open · 2025Article
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Authors and funding
9 authors.
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Abstract
BACKGROUND AND
objectivesPreterm birth (PTB) affects ~10% of births worldwide; however, most literature focused on short-term clinical outcomes, with much less focus on long-term socioeconomic outcomes after PTB. We examined associations between PTB and individuals' income, employment, and educational outcomes during early adulthood.
methodsWe conducted a population-level matched cohort study including all live births in Canada between 1990 and 1996, followed until 2018. Outcomes included Employment income per year in 2018 CAD and employment between ages 18 and 28 years, postsecondary education enrollment (18-22 years), and maximum educational attainment at age 22-27 years. Mean differences and risk ratios (RR) and differences (RD) were estimated using generalized estimating equation regression models for economic outcomes and multinomial logistic regression models for educational outcomes.
resultsOf 2.4 million births, 7% were born preterm (0.3%, 0.6%, 0.8%, and 5.4% born extremely preterm (24-27 weeks), very preterm (28-31 weeks), moderately preterm (32-33 weeks), and late preterm (34-36 weeks) respectively). After matching on baseline characteristics (e.g., sex, province of birth, and parental demographics) and adjusting for age and period effects, preterm-born individuals, on average, had $958 CAD less employment income per year (95% CI: $854-$1062), 6% lower income per year, than term-born individuals, and were 2.13% less likely to be employed (1.98-2.29%). PTB was also negatively associated with university enrollment (RR 0.93 (0.91-0.94) and graduation with a university degree (RR 0.95 (0.94-0.97)). Mean income differences for those born 24-27 weeks were -$5,463 CAD per year (17% lower), and adjusted RR were 0.55 for university enrollment and graduation.
conclusionIn this population-based study, preterm birth was associated with lower economic and educational achievements at least until the late twenties. The associations were stronger with decreasing GA at birth. Policymakers, clinicians, and parents should be aware that the socioeconomic impact of PTB is not limited to the early neonatal period but extends into adulthood.
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