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Children born preterm may experience learning challenges that continue into adulthood. Although survival after preterm birth has improved greatly, less is known about long-term educational outcomes. This large case-control study from Quebec, Canada, included 297,820 individuals and compared those born preterm with matched peers born full term. The findings are especially relevant for parents of preterm infants and neonatal nurses. The study found that individuals born preterm were less likely to complete high school or earn a university degree, while social and family factors had an even greater influence on educational outcomes.
Children born preterm may need extra support long after leaving the neonatal unit. Brain development continues throughout late pregnancy, so being born early can affect later learning and development. Researchers wanted to understand whether preterm birth influences educational outcomes into adulthood and how much other social factors contribute to those outcomes.
To answer this question, researchers analyzed education records for all individuals born preterm in Quebec, Canada, between 1976 and 1995 and compared them with matched individuals born full term. They examined final high school grades, high school graduation by age 22 years, and university degree attainment during adulthood.
The study found that educational attainment became more challenging as gestational age decreased. Individuals born extremely preterm had the highest likelihood of not graduating from high school or obtaining a university degree, followed by those born very preterm and moderate-to-late preterm. However, among individuals who remained in the standard school system, final high school grades were very similar regardless of whether they had been born preterm or full term.
Researchers also found that preterm birth was only one part of the picture. Maternal education, neighborhood socioeconomic status, male sex, and migration-related factors had an even stronger association with educational outcomes than preterm birth itself. These findings highlight the importance of considering both medical and social circumstances when supporting children born preterm.
For parents of preterm infants and healthcare professionals, these findings support the value of long-term developmental and educational follow-up. Children born preterm may benefit from early identification of learning difficulties and continued support throughout their school years. At the same time, the study shows that family and social circumstances also play an important role in educational success, reinforcing the need for comprehensive support.
Many individuals born preterm achieve educational success, especially when they receive appropriate support. Parents and health professionals can work together to monitor development, discuss school progress, and seek additional help whenever concerns arise.
Paper available at: JAMA Network Open, “Long-Term Educational Outcomes of Individuals Born Preterm”
Full list of authors: Loose, T.; Collet, O.; Nuyt, A. M.; Goulet-Pelletier, J.-C.; Worrell, F. C.; Côté, S.; Luu, T. M.
DOI: 10.1001/jamanetworkopen.2025.34918
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