Maternal and Child Health Journal

, Volume 21, Issue 1, pp 199–207 | Cite as

Reading, Mathematics and Fine Motor Skills at 5 Years of Age in US Children who were Extremely Premature at Birth

  • Miryoung LeeEmail author
  • John M. Pascoe
  • Caroline I. McNicholas


Objectives The prevalence of extreme prematurity at birth has increased, but little research has examined its impact on developmental outcomes in large representative samples within the United States. This study examined the association of extreme prematurity with kindergarteners’ reading skills, mathematics skills and fine motor skills. Methods The early childhood longitudinal study-birth cohort, a representative sample of the US children born in 2001 was analyzed for this study. Early reading and mathematics skills and fine motor skills were compared among 200 extremely premature children (EPC) (gestational age <28 wks or birthweight <1000 g), 500 premature children (PC), and 4300 term children (TC) (≥37wks or ≥2500 g). Generalized linear regression analyses included sampling weights, children’s age, race, sex, and general health status, and parental marital status and education among singleton children. Results At age 5 years, EPC were 2.6(95 % CI 1.7–3.8) times more likely to fail build a gate and were 3.1(95 % CI 1.6–5.8) times more likely to fail all four drawing tasks compared to TC (p values <0.001). Fine motor performance of PC (failed to build a gate, 1.3[95 % CI 1.0–1.7]; failed to draw all four shapes, 1.1[95 % CI 0.8–1.6]) was not significantly different from TC. Mean early reading scale score (36.8[SE:1.3]) of EPC was 4.0 points lower than TC (p value < 0.0001) while mean reading score (39.9[SE:1.4]) of PC was not significantly different from TC (40.8[SE:1.1]). Mean mathematics scale score were significantly lower for both EPC (35.5[SE:1.0], p value < 0.001) and PC (39.8[SE:0.8], p value = 0.023) compared to TC (41.0[SE:0.6]). Conclusions for Practice Extreme prematurity at birth was associated with cognitive and fine motor delays at age 5 years. This suggests that based on a nationally representative sample of infants, the biological risk of extreme prematurity persists after adjusting for other factors related to development.


Preterm Low birth weight Early childhood longitudinal study-birth cohort Childhood development 



Restricted use of ECLS-B data were obtained by approval and permission of the Institute of Education Sciences (IES) Data Security Office of the U.S. Department of Education, National Center for Education Statistics. We are grateful for multiple sponsoring organizations and IES Data Security Office for their assistance. The material contained in this study has been partly presented as an abstract at the 52nd Annual Meeting of the European Society for Paediatric Research in 2011. This research was a non-funded study.

Compliance with Ethical Standards

Conflicts of interest

The authors declare that they have no conflict of interest.

Supplementary material

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Supplementary material 1 (DOCX 22 kb)


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Miryoung Lee
    • 1
    • 2
    Email author
  • John M. Pascoe
    • 1
  • Caroline I. McNicholas
    • 1
  1. 1.Department of Pediatrics, Boonshoft School of MedicineWright State UniversityDaytonUSA
  2. 2.Department of Community Health, Lifespan Health Research Center, Boonshoft School of MedicineWright State UniversityDaytonUSA

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