TOPLINE:

Preterm birth and low birth weight were associated with lower intelligence quotient (IQ), poorer academic performance, and a greater need for special educational support. Stronger associations were noted for earlier gestational ages and lower birth weights.

METHODOLOGY:

• Researchers conducted an umbrella review and meta-analysis to investigate the associations between preterm birth or low birth weight and cognitive or educational outcomes.
• They synthesized evidence from 40 systematic reviews (22 with meta-analyses and 18 with narrative syntheses) that included studies involving children, adolescents, or adults.
• Cognitive outcomes were measured as general cognitive ability using age-appropriate standardized instruments, which included developmental assessments and IQ tests. Educational outcomes were classified into four areas: academic attainment, type and length of schooling, need for additional educational support, and educational costs.
• The dataset comprised 788 effect estimates from primary studies.
• Subgroup analyses explored associations based on gestational age, birth weight, and age at assessment.

TAKEAWAY:

• Individuals born preterm or with low birth weight had reduced general, nonverbal, and verbal IQs.
• Academic performance was poorer among individuals born preterm or with low birth weight in measures of reading, word identification, and spelling. The magnitude of the associations decreased with increasing gestational age or birth weight and attenuated with increasing age.
• Individuals born preterm or with low birth weight had a higher likelihood of having special educational needs.
• The academic performance of children born preterm or with low birth weight was rated lower by teachers; self-assessments and evaluations by mothers also indicated poorer performance.

IN PRACTICE:

“Preterm birth and low birth weight were associated with persistent cognitive and educational disadvantages across the life course, underscoring the importance of early identification and long-term monitoring to inform health and educational planning,” the authors of the study wrote.

SOURCE:

The study was led by Mingzheng Hu, MMed, of the Nuffield Department of Primary Care Health Sciences at the University of Oxford in Oxford, England. It was published online on March 30, 2026, in JAMA Pediatrics.

LIMITATIONS:

Individual-level data were unavailable, so subgroup analyses used the maximum gestational age from each study sample, which differs from the World Health Organization’s definitions of preterm.

DISCLOSURES:

One author reported receiving funding through a China Scholarship Council-University of Oxford scholarship, and another author reported receiving support from the UK National Institute for Health Research, among others.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.