Gestational Age and Socioeconomic Achievements in Young Adulthood A Danish Population-Based Study

Bil­steen et al, JAMA, Decem­ber 14, 2018

Impor­tance  The poor health out­comes asso­ci­at­ed with preterm birth are well estab­lished. How­ev­er, it is less clear how small vari­a­tions in ges­ta­tion­al age, even with­in the term range, are asso­ci­at­ed with long-term oppor­tu­ni­ties and well-being, as mea­sured by socioe­co­nom­ic out­comes in adult­hood.

Objec­tive  To exam­ine the asso­ci­a­tion of ges­ta­tion­al age at birth with edu­ca­tion­al achieve­ment, income, and pri­ma­ry source of income in adult­hood.Design, Set­ting, and Par­tic­i­pants  This Dan­ish pop­u­la­tion-based, reg­is­ter-based cohort study exam­ined all live-born sin­gle­tons born in Den­mark from 1982 to 1986 with­out con­gen­i­tal anom­alies and who lived in Den­mark at age 28 years. Data analy­sis was con­duct­ed from Novem­ber 2, 2017, to June 15, 2018.

Results  In a pop­u­la­tion of 228 030 sin­gle­tons , 36.3% had a ter­tiary edu­ca­tion at age 28 years. Among adults born at 22 to 27 weeks of ges­ta­tion, 21.6% had a ter­tiary edu­ca­tion, and 23.2% had an income in the high­est ter­tile. Using 40 weeks of ges­ta­tion as the ref­er­ence,

Con­clu­sions and Rel­e­vance  Short­er ges­ta­tion­al dura­tion even with­in the term range was asso­ci­at­ed with poor­er socioe­co­nom­ic out­comes in adult­hood. While adults born at 35 to 38 weeks of ges­ta­tion expe­ri­enced only slight­ly increased risk of adverse socioe­co­nom­ic out­comes, this may have a sig­nif­i­cant impact on pub­lic health, since a large pro­por­tion of all chil­dren are born in these weeks.