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The combined influence of parental education and preterm birth on school performance
  1. Marit Gisselmann1,
  2. Ilona Koupil1,
  3. Bianca L De Stavola2
  1. 1Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
  2. 2Medical Statistics Unit (MSU), Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, University of London, London, UK
  1. Correspondence to Dr Marit Gisselmann, Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, 106 91 Stockholm, Sweden; marit.gisselmann{at}


Background Social background and birth characteristics are generally found to be independently associated with school achievements but the underlying mechanisms are not fully understood. This study aimed to explore how parental education and shorter gestational age jointly influence school performance in a cohort of Swedish children.

Methods 10 835 children born between 1973 and 1981 were studied, the third generation of the register-based Uppsala Multigenerational Birth Cohort. Ordinal logistic regression models were fitted to estimate OR of achieving middle and high grades in Swedish language at age 16 years, relative to low grade, by parental education and own gestational age, adjusting for potential confounders.

Results In children from families with lower parental education, the adjusted OR of receiving a higher grade was 0.54 (95% CI 0.41 to 0.71) for preterm (<37 completed weeks) compared with full-term births. This estimate did not change when adjusted for several potential confounders (0.59; CI 0.44 to 0.79). When different cut-points were selected to define preterm birth, the estimated OR for those with low parental education decreased linearly from 0.83 (CI 0.72 to 0.96) using less than 39 weeks as the cut-point, to 0.52 (CI 0.30 to 0.90) using less than 35 weeks. There was no evidence of significant effects of shorter gestational age for children with parents from other educational groups.

Conclusions The disadvantage of shorter gestational age on the chance of achieving higher grades in Swedish language was confined to children from families in which none of the parents had higher education. This suggests that the detrimental influence of shorter gestational age on school performance in language may be avoidable.

  • Educational status
  • gestational age
  • premature infants
  • school performance
  • social paediatrics

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  • Funding The UBCoS Multigen study is supported by grants from the Swedish Council for Working Life and Social Research (grant no 2007-1010) and the Swedish Research Council (2006-7498). MG (grant no 2008-1309) and IK (grant no 2006-1518) are currently funded by the Swedish Council for Working Life and Social Research. BLdS was supported by a travel grant from the Swedish Council for Working Life and Social Research (grant no 2006-1276) while working on this study.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Regional Ethics Ccommittee in Stockholm (Dnr 03-117, 04-944T).

  • Provenance and peer review Not commissioned; externally peer reviewed.