SCHOOL PERFORMANCE AT 9 YEARS OF AGE IN VERY PREMATURE AND VERY-LOW-BIRTH-WEIGHT INFANTS - PERINATAL RISK-FACTORS AND PREDICTORS AT 5 YEARSOF AGE

To assess the impact of both perinatal disorders and developmental pro blems identified at preschool age on school performance, we followed a virtually complete birth cohort of very premature (<32 completed week s of gestation) and very low birth weight infants until they were 9 ye ars of age. In 84% of the survivors (n = 813), data on school performa nce were available for analysis. At the age of 9 years, 19% of the chi ldren were in special education. Of the children in mainstream educati on, 32% were in a grade below the appropriate level for age and 38% ha d special assistance. After correction for other perinatal items, chil dren of low socioeconomic status and boys had significantly higher adj usted odds ratios for special education. Logistic regression with a pe rinatal and a 5-year time category showed that the most predictive fac tors for special education were developmental delay, neuromotor and sp eech/language function, inattention and hyperactivity score, total pro blem score, and reported school results at the age of 5 years. When ch ildren with disabilities were left out of the analysis, the importance of neuromotor function and total problem score disappeared. Increased risks of any school failure in nondisabled children included mild or severe developmental delay and marginal or poor school performance at the age of 5 years. Long-term follow-up with specific attention to the se predictors at 5 years of age, although time-consuming, is necessary .