Does neighborhood deprivation modify the effect of preterm birth on children's first grade academic performance?. (May 2015)

• Record Type: Journal Article
• Authors: Richards, Jennifer L.; Chapple-McGruder, Theresa; Williams, Bryan L.; Kramer, Michael R.
• Is Part Of: Social science & medicine. Volume 132(2015)
• Page Start: 122
• Page End: 131
• Publication Date: 2015-05
• Subjects: Preterm birth -- Neighborhood deprivation -- Socioeconomic status -- Academic achievement -- Interaction; Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; Medicine -- Periodicals; Médecine sociale -- Périodiques; Anthropologie médicale -- Périodiques; Santé publique -- Périodiques; Psychologie -- Périodiques; Médecine -- Périodiques; Electronic journals; 362.105
• DOI: 10.1016/j.socscimed.2015.03.032
• Languages: English
• ISSNs: 0277-9536

Abstract

Abstract: Children's cognitive development and academic performance are linked to both fetal and early childhood factors, including preterm birth and family socioeconomic status. We evaluated whether the relationship between preterm birth (PTB) and first grade standardized test performance among Georgia public school students was modified by neighborhood deprivation in early childhood. The Georgia Birth to School cohort followed 327, 698 children born in Georgia from 1998 to 2002 through to end-of-year first grade standardized tests. Binomial and log-binomial generalized estimating equations were used to estimate risk differences and risk ratios for the associations of both PTB and the Neighborhood Deprivation Index for the census tract in which each child's mother resided at the time of birth with test failure (versus passing). The presence of additive and multiplicative interaction was assessed. PTB was strongly associated with test failure, with increasing risk for earlier gestational ages. There was positive additive interaction between PTB and neighborhood deprivation. The main effect of PTB versus term birth increased risk of mathematics failure: 15.9% (95%CI: 13.3–18.5%) for early, 5.0% (95% CI: 4.1–5.9%) for moderate, and 1.3% (95%CI: 0.9–1.7%) for late preterm. Each 1 standard deviation increase in neighborhood deprivation was associated with 0.6% increased risk of mathematics failure. For children exposed to both PTB and higher neighborhood deprivation, test failure was 4.8%, 1.5%, and 0.8% greater than the sum of two main effects for early, moderate, and late PTB, respectively. Results were similar, but slightly attenuated, for reading and English/language arts. Our results suggest that PTB and neighborhood deprivation additively interact to produce greater risk among doubly exposed children than would be predicted from the sum of the effects of the two exposures. Understanding socioeconomic disparities in the effect of PTB on academic outcomes at school entry is important for targeting of early childhood interventions. Highlights: Preterm children more likely to fail Georgia's 1st grade standardized tests. Gradient effect showed increased risk of test failure with earlier birth. Living in more deprived neighborhood was modest predictor of test failure. Neighborhood deprivation modifies effect of preterm birth on school achievement. Double-jeopardy of preterm birth and area-based deprivation increases risk.