Gestational age at birth, chronic conditions, and school outcomes: Young person's version of a research paper

This study was summarised by Sara Duru during her eight-week internship at ADR England, with input and feedback from the Education and Child Health Insights from Linked Data (ECHILD) team who produced the original research. It looks at academic outcomes and special education needs across gestational age, for children born with and without chronic health conditions (e.g. long-term conditions affecting the brain, lungs, or heart). 

'Gestational age’ means how far into their mother’s pregnancy a baby is born. Most pregnancies last 39 or 40 weeks (just over nine months), but anything over 37 weeks is classed as full term by clinicians. Babies born before 37 weeks of gestation are called ‘preterm’. See the glossary on the final page for a description of the commonly used terms throughout the paper.

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What did the study do?

This study used de-identified information about children’s education and health (from the ECHILD project) to examine:

• the education outcomes of pupils in England at Key Stage 1 (KS1) (age 7) and Key Stage 2 (KS2) (age 11)
• special educational needs by age 11, considering how far into pregnancy they were born (gestational age), birth size, and early chronic conditions identified by age 2.

Who is in the study?

306,717 pupils attending state schools in England who were born between 1 September 2004 and 31 August 2005.

What did the study find?

1. Children born even a few weeks early, at 37-38 weeks of pregnancy, were less likely to meet expected levels of attainment in KS1 and KS2 compared to those born at 40 weeks. Special educational needs also increased with a shorter length of pregnancy.
2. A greater proportion of children with special educational needs or not achieving expected levels of attainment in KS1 and KS2 was attributable to them having chronic conditions, rather than being born preterm (at less than 37 weeks).
3. Children with a lower birthweight, living in a more deprived area, born later in the school year, born to a younger mother, and with older siblings were more likely to have special educational needs.
4. Children who were born in the autumn were more likely to achieve expected academic outcomes than those born in the summer, likely due to their older age at school start.

What needs to change?

• Increasing support for children with special educational needs and/or chronic conditions
• Equipping educational professionals to support the needs of children born preterm
• Providing support that facilitates healthy behaviours for the most vulnerable mothers
• Providing additional support prior to school entry for summer-born preterm children

Key message

Research using the ECHILD database could help to guide policy on offering early assistance to children who are at risk of experiencing poor outcomes during their school years.