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What We Now Know About Kids Who Were Born Very Premature

Tiny infant in incubator, clinging to life.
Photograph by Getty Images

It is common for parents whose child was born premature to worry about hitting the right milestones at the right time, their education and, of course, their future. Once it's clear their new baby's life is no longer in danger, the questions start: What if their brain never fully develops? What if my kid can't handle the pressure at school? What if they aren’t able to get into a decent college?

But while children born prematurely often face obstacles immediately after birth and even in the first couple of years, a new study found that the majority—a full two-thirds born at 23 or 24 weeks gestation—were totally ready for kindergarten—wait for it—on time.

These and other new findings from the Institute for Policy Research at Northwestern University and Northwestern Medicine should put preemies' parents' minds at ease. A massive study, recently published in JAMA Pediatrics, found that in addition to being ready for kindergarten, nearly 2 percent of the preemie cohort were even classified as gifted at school.

The longitudinal study analyzed more than 1.3 million babies born in Florida from 1992 to 2002 and went on to attend public schools between 1995 and 2012. Scientists then matched the babies' vital statistic records with their Florida public school records to examine the association between being born early and educational performance. The study included babies who had been born anywhere from 23 to 41 weeks gestation.

Most infants born at 23 to 24 weeks still demonstrate a high degree of cognitive functioning at the start of kindergarten and throughout school.

The extremely premature babies frequently scored low on the standardized tests, but those born even at 25 weeks scored only slightly lower than the full-term infants. David Figlio, director of the Institute for Policy Research at Northwestern University said the findings show "the glass is more than half full" for very premature babies, since the difference in test scores between those born at 28 weeks or later and full-term infants wound up being negligible.

And even those born earlier weren't doomed. "Most infants born at 23 to 24 weeks still demonstrate a high degree of cognitive functioning at the start of kindergarten and throughout school,” Figlio said.

Though data provided during the study did not account for some of these infants' medical issues related to preterm birth or share information about school performance (such as biological make-up or additional support from family, teachers or administrators), most of the children born prematurely ended up performing reasonably well on standardized tests through middle school.

The research, in any case, is important, especially for new parents in the thick of caring for their very premature newborns. Get through the difficult early years and, chances are, your child will be fine—great even.

"Many studies look at premature babies but very few of them look at their educational outcomes into middle school in such a large population," Dr. Craig Garfield, associate professor of pediatrics and medical social sciences at Northwestern University Feinberg School of Medicine, said. “What's special about this study is it speaks to the importance of administrative data sets and the ability to combine different data sets in ways that allow us to ask questions and get answers about how our children are doing in the long-run."

The underlying message for parents of a child born prematurely is this: Even the healthiest boy or girl will benefit from an extracurricular push in the right direction. Don’t be afraid to give yours a nudge every now and then.

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