The Impact of Premature Birth on Maths Achievement and Schooling

This study aimed to quantify the type and severity of learning difficulties experienced by children born prematurely (up to 36 weeks), and in particular to understand the origins and nature of mathematics problems.

It analysed data from six large-scale longitudinal studies: the Millennium Cohort Study, the Avon Longitudinal Study of Parents and Children (ALSPAC), the British Cohort Study, the National Child Development Study, the Bavarian Longitudinal Study (BLS), and the EPICure Study.

The researchers also used these datasets to investigate:

  • What are the long term consequences of maths and other learning difficulties?
  • Would delayed or deferred school entry benefit very preterm children’s school performance?
  • What do teachers and parents know about the outcomes and schooling problems of preterm children?
Findings and recommendations
  • Moderately, very and extremely preterm children, born before 34 weeks of gestation, are more likely to have cognitive deficits and learning difficulties than children born at term. The risk for such difficulties increases with decreasing gestation at birth.
  • Preterm children’s learning problems in primary school, in particular difficulties with mathematics, are associated with lower wealth in adulthood.
  • Many parents consider delayed school entry as one intervention that may help their preterm children to do better at school. Our findings, based on the largest investigation to date, do not support this. Rather, preterm children may benefit from entering school at the appropriate age but receiving additional support in school.
  • Teachers and educational psychologists receive little formal training about preterm birth and are often not aware of appropriate strategies to support preterm children in the classroom. Informing teachers about the special constellation of problems following preterm birth is crucial in preparing them to support the growing number of preterms entering schools in the coming years.
  • All preterm children born before 34 weeks of gestation should have regular follow-up. Interventions are required around the time of school entry to facilitate preterm children to have an optimal start to their schooling career.
  • Delayed school entry is not recommended on current evidence, but more research is needed. Education professionals require more training about the specific difficulties faced by preterm children, and tailored new approaches to teaching preterm children are needed.
What is meant by preterm?

Each year in England, around 10,000 children are born very preterm (at less than 32 weeks gestation) and a further 60,000 are born moderately preterm (at 32-36 weeks gestation).

The number of preterm births has increased in the last two decades, and more preterm children are surviving due to improved neonatal care. However, the prevalence of cognitive, behavioural and emotional problems in preterm populations has not changed. In particular, children born preterm have been found to experience specific learning problems including difficulties with mathematics, visual-spatial skills, memory and attention.

There is still much we do not know about the nature and spectrum of these learning difficulties, their long term consequences, and how to deal with them. In particular, there is controversy about whether moderately preterm children experience similar but milder learning problems.

Project details



Professor Dieter Wolke, Unversity of Warwick; Dr Samantha Johnson, University of Leicester; Dr Julia Jaekel, University of Tennessee; Dr Camilla Gilmore, Loughborough University

Grant amount and duration:


1 November 2012 – 31 August 2017