University of Oulu

Bilsteen, J. F., Alenius, S., Bråthen, M., Børch, K., Ekstrøm, C. T., Kajantie, E., Lashkariani, M., Nurhonen, M., Risnes, K., Sandin, S., van der Wel, K. A., Wolke, D., & Andersen, A.-M. N. (2022). Gestational age, parent education, and education in adulthood. Pediatrics, 149(1), e2021051959.

Gestational age, parent education, and education in adulthood

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Author: Bilsteen, Josephine Funck1,2; Alenius, Suvi3,4; Bråthen, Magne5;
Organizations: 1Department of Paediatrics, Hvidovre University Hospital, Hvidovre, Denmark
2Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
3Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
4Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
5Department of Social Work, Child Welfare and Social Policy, Oslo Metropolitan University, Norway
6Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
7Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
8PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
9Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
10Department of Research, Innovation, and Education and Children’s Clinic, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
11Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
12Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
13Seaver Autism Center for Research and Treatment at Mount Sinai, New York, New York
14Department of Psychology and Centre of Early Life, University of Warwick, Coventry, United Kingdom
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1 MB)
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Language: English
Published: American Academy of Pediatrics, 2022
Publish Date: 2022-04-27


Background: Adults born preterm (<37 weeks) have lower educational attainment than those born term. Whether this relationship is modified by family factors such as socioeconomic background is, however, less well known. We investigated whether the relationship between gestational age and educational attainment in adulthood differed according to parents’ educational level in 4 Nordic countries.

Methods: This register-based cohort study included singletons born alive from 1987 up to 1992 in Denmark, Finland, Norway, and Sweden. In each study population, we investigated effect modification by parents’ educational level (low, intermediate, high) on the association between gestational age at birth (25–44 completed weeks) and low educational attainment at 25 years (not having completed upper secondary education) using general estimation equations logistic regressions.

Results: A total of 4.3%, 4.0%, 4.8%, and 5.0% singletons were born preterm in the Danish (n = 331 448), Finnish (n = 220 095), Norwegian (n = 292 840), and Swedish (n = 513 975) populations, respectively. In all countries, both lower gestational age and lower parental educational level contributed additively to low educational attainment. For example, in Denmark, the relative risk of low educational attainment was 1.84 (95% confidence interval 1.44 to 2.26) in adults born at 28 to 31 weeks whose parents had high educational level and 5.25 (95% confidence interval 4.53 to 6.02) in adults born at 28 to 31 weeks whose parents had low educational level, compared with a reference group born at 39 to 41 weeks with high parental educational level.

Conclusions: Although higher parental education level was associated with higher educational attainment for all gestational ages, parental education did not mitigate the educational disadvantages of shorter gestational age.

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Series: Pediatrics
ISSN: 0031-4005
ISSN-E: 1098-4275
ISSN-L: 0031-4005
Volume: 149
Issue: 1
Article number: e2021051959
DOI: 10.1542/peds.2021-051959
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
Funding: Supported by Research on European Children and Adults born Preterm (RECAP preterm). RECAP preterm has received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement 733280. In addition, the study was supported by Welfare state life courses: Social inequalities in the coevolution of employment, health and critical life events, which was supported by grant 75970 from the NordForsk program, Nordic Program on Health and Welfare: Nordic Register Pilots: Contingent Life Courses. Additionally, this study was supported by PREMLIFE Norface DIAL Programme award 462-16-040 PREMLIFE (Life Course Dynamics after Preterm Birth) Protective Factors for Social and Educational Transitions, Health, and Prosperity, Academy of Finland (grant 315690), Finnish Foundation for Pediatric Research, Novo Nordisk Foundation, Sigrid Jusélius Foundation.
Copyright information: © 2021 by the American Academy of Pediatrics. This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.