Maternal education and language development at 2 years corrected age in children born very preterm: results from a European population-based cohort study
Year: 2020
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Socioeconomic factors influence language development in the general population, but the association remains poorly documented in children born very preterm (VPT). We assessed the impact of maternal education on language development in children born VPT and effect modification by perinatal risk. METHODS: Data were from the Effective Perinatal Intensive Care in Europe (EPICE) population-based cohort of children born <32 weeks' gestational age (GA) in 2011/2012. Regions from six countries (Estonia, France, Germany, Italy, Sweden and UK) used a validated short form MacArthur Developmental Communicative Inventories Checklist to assess language at 2 years corrected age. Perinatal variables were collected from clinical records. We assessed expressive language delay (ELD), defined as (a) not combining words; and (b) expressive vocabulary <10th percentile of norms for age and sex. Perinatal risk (low, moderate and high) was determined using GA, small for GA and neonatal morbidities. We estimated adjusted risk ratios (aRR) of ELD by maternal education with inverse weighting to account for non-response bias. RESULTS: Of 2741 children, 24.6% were not combining words and 39.7% had a low expressive vocabulary. Low maternal education (lower secondary or less compared with a bachelor's degree or more) increased risks of ELD: not combining words: aRR=1.52 (95% CI 1.36 to 1.69); low expressive vocabulary: aRR=1.25 (1.04 to 1.51). For children with low perinatal risk, the aRR were 1.88 (1.26 to 2.80) and 1.44 (1.06 to 1.95), respectively, compared with those with high perinatal risks: 1.36 (1.10 to 1.67) and 1.11 (0.97 to 1.27), respectively. CONCLUSION: Low maternal education affects ELD for children born VPT, although the association appears attenuated among those with highest perinatal risk.
Institutions: Inserm, Université Paris Cité, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, Centre de Recherche Épidémiologie et Statistique, Institut National de la Recherche Agronomique, University of Leicester, Université Catholique de Lille, Groupe Hospitalier de l'Institut Catholique de Lille, Hôpital Saint-Vincent-de-Paul, Karolinska Institutet, Bambino Gesù Children's Hospital, Philipps University of Marburg, Tartu University Hospital, University of Tartu
Language: English
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funder: European Commission
OpenAlex ID: W3003265300