Original Article
Preterm Birth and Dyscalculia

https://doi.org/10.1016/j.jpeds.2014.01.069Get rights and content

Objective

To evaluate whether the risk for dyscalculia in preterm children increases the lower the gestational age (GA) and whether small-for-gestational age birth is associated with dyscalculia.

Study design

A total of 922 children ranging from 23 to 41 weeks' GA were studied as part of a prospective geographically defined longitudinal investigation of neonatal at-risk children in South Germany. At 8 years of age, children's cognitive and mathematic abilities were measured with the Kaufman Assessment Battery for Children and with a standardized mathematics test. Dyscalculia diagnoses were evaluated with discrepancy-based residuals of a linear regression predicting children's math scores by IQ and with fixed cut-off scores. We investigated each GA group's ORs for general cognitive impairment, general mathematic impairment, and dyscalculia by using binary logistic regressions.

Results

The risk for general cognitive and mathematic impairment increased with lower GA. In contrast, preterm children were not at increased risk of dyscalculia after statistically adjusting for child sex, family socioeconomic status, and small-for-gestational age birth.

Conclusion

The risk of general cognitive and mathematic impairments increases with lower GA but preterm children are not at increased risk of dyscalculia.

Section snippets

Methods

Data were collected as part of the prospective Bavarian Longitudinal Study.20, 24 Participating parents were approached within 48 hours of the infant's hospital admission and were included in the study with written consent. At 8 years of age, children were assessed by an interdisciplinary study team, including neurologic (done by pediatricians) and cognitive assessments (done by psychological assistants). All assessors were blind to group membership. Ethical permission for the study was granted

Results

With lower GA, disproportionally more children were affected by both general cognitive and mathematic impairment, as well as dyscalculia (Table). Logistic regressions showed that the risk for general cognitive and mathematic impairment incrementally increased with lower GA, after we statistically adjusted it for child sex, family SES, and SGA status. Figure 2 shows that, compared with healthy, full-term controls, very and moderately preterm children were at increased risk of both general

Discussion

With earlier GA at birth, children are at increased risk of general cognitive and mathematic impairments, and this risk is independent of SGA birth. In contrast, preterm children are not at increased risk of dyscalculia after we statistically adjusted for child sex, family SES, and SGA birth. SGA children across the whole GA range were at increased risk for a discrepancy-based dyscalculia diagnosis but not for a fixed cut-off score diagnosis.

These findings rebut suggestions that very preterm

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    Supported by the German Research Foundation (JA 1913) and the German Federal Ministry of Education and Science (PKE24, JUG14, 01EP9504, and 01ER0801). The authors declare no conflicts of interest.

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