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Off Topic: Premature birth results in less schooling and income (age 28, 228,000 Danes) – Dec 2018

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

J JAMA Netw Open. 2018;1(8):e186085. doi:10.1001/jamanetworkopen.2018.6085
osephine Funck Bilsteen, MSc1,2; David Taylor-Robinson, PhD3; Klaus Børch, PhD1; et al Katrine Strandberg-Larsen, PhD2; Anne-Marie Nybo Andersen, PhD2

VitaminDWiki

Signicant problems for pregnancies <36 weeks
Note: More Vitamin D/Omega-3 ==> fewer premature births, healthier moms, healthier children

 

Vitamin D Helps

Omega-3 Helps

Healthy pregnancies need lots of vitamin D has the following summary

Problem
ReducesEvidence
0. Chance of not conceiving3.4 times Observe
1. Miscarriage 2.5 times Observe
2. Pre-eclampsia 3.6 timesRCT
3. Gestational Diabetes 3 times RCT
4. Good 2nd trimester sleep quality 3.5 times Observe
5. Premature birth 2 times RCT
6. C-section - unplanned 1.6 timesObserve
     Stillbirth - OMEGA-3 4 timesRCT - Omega-3
7. Depression AFTER pregnancy 1.4 times RCT
8. Small for Gestational Age 1.6 times meta-analysis
9. Infant height, weight, head size
     within normal limits
RCT
10. Childhood Wheezing 1.3 times RCT
11. Additional child is Autistic 4 times Intervention
12.Young adult Multiple Sclerosis 1.9 timesObserve
13. Preeclampsia in young adult 3.5 timesRCT
14. Good motor skills @ age 31.4 times Observe
15. Childhood Mite allergy 5 times RCT
16. Childhood Respiratory Tract visits 2.5 times RCT

RCT = Randomized Controlled Trial


From the web__

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Societal Costs of Preterm Birth (age 0-7 years)- Chapter in 2007 book

  • Preterm birth in the United States was at least $26.2 billion in 2005 (first year)
  • Special education services associated with a higher prevalence of four disabling conditions among premature infants added $1.1 billion.
  • Lost household and labor market productivity associated with those disabilities contributed $5.7 billion.
    • Appears to ignore all costs to society after age 7

 Download the PDF from VitaminDWiki

 Download the PDF from VitaminDWiki

Educational level

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Income achieved

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Source of Income

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For < 34 weeks: >1.5 X more likely to be on welfare, >2.3 X more likely to be on disability

Key Points

  • Question How was the whole range of gestational age at birth associated with socioeconomic outcomes in adulthood (education, personal income, and primary source of income)?
  • Findings In this cohort study including 228 030 singletons, lower gestational age (<39 weeks of gestation) was associated with lower odds of high educational level and high personal income and increased odds of receiving disability pension and cash welfare benefits compared with individuals born at 40 weeks of gestation.
  • Meaning These findings suggest that lower gestational age even within the term range may have implications for long-term opportunities and well-being as measured by socioeconomic outcomes in adulthood.

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.

Exposures Gestational age at birth in completed weeks (22-45 weeks).

Main Outcomes and Measures Educational attainment, personal income, and primary source of income at age 28 years.

Results In a population of 228 030 singletons (4.0% preterm, 12.1% early term; 49.4% female), 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, the adjusted odds ratio for tertiary education for individuals born at 22 to 27 weeks of gestation was 0.21 (95% CI, 0.13-0.35) and the corresponding figures for 28 to 31, 33, 36, 38, and 43 to 45 weeks of gestation were 0.45 (95% CI, 0.37-0.55), 0.67 (95% CI, 0.54-0.83), 0.84 (95% CI, 0.77-0.93), 0.85 (95% CI, 0.81-0.89), and 0.93 (95% CI, 0.83-1.04), respectively. The adjusted odds ratio for highest income tertile for individuals born at 22 to 27 weeks of gestation was 0.66 (95% CI, 0.41-1.06) and the corresponding figures for 28 to 31, 33, 36, 38, and 43 to 45 weeks of gestation were 0.80 (95% CI, 0.68-0.94), 0.77 (95% CI, 0.63-0.93), 0.89 (95% CI, 0.82-0.96), 0.95 (95% CI, 0.91-0.99), and 1.00 (95% CI, 0.91-1.12), respectively. All estimates were adjusted for sex, birth year, parity, maternal age, maternal education, and maternal country of origin.

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.

Created by admin. Last Modification: Saturday December 15, 2018 22:20:17 GMT-0000 by admin. (Version 10)

Attached files

ID Name Comment Uploaded Size Downloads
11056 Preterm Birth - Causes, Consequences.pdf admin 15 Dec, 2018 21:48 3.16 Mb 148
11055 1990 2006.jpg admin 15 Dec, 2018 21:23 30.45 Kb 66
11054 Income category.jpg admin 15 Dec, 2018 20:33 41.65 Kb 67
11053 Income level.jpg admin 15 Dec, 2018 20:33 25.21 Kb 66
11052 Educational Level.jpg admin 15 Dec, 2018 20:32 25.45 Kb 63
11051 Prematurity Danes.pdf PDF 2018 admin 15 Dec, 2018 20:32 915.55 Kb 40
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