Premature summer-born children face ‘significant’ challenges at school

Wednesday, August 14, 2019

New research reveals being born just three weeks premature can impact upon children's development, particularly if it means they fall into an earlier school year.

Carried out by the University of Leeds, the research finds that children born just three weeks premature, who consequently fall into an earlier school year, are more likely to experience ‘significant setbacks’ in their education.

Using data from the Born in Bradford birth cohort study, the researchers found that the odds of children born prematurely not achieving a 'good' level of development at the end of Reception, were approximately twice as high as those for children born at full term.

Researchers analysed data on 10,000 children involved in the cohort study.

The children most at risk were those born prematurely in the summer months (June to August), who consequently started school a year earlier than expected. These children were three times less likely to reach a ‘good level of development’ compared to other children born prematurely during the summer, whose early arrival didn’t change the year they started Reception.

Researchers also found that holding premature children back from starting school by a year may not compensate for their early birth.

The research, which aimed to understand whether extra support might be necessary for some children born moderately premature, was in response to conversations with schools participating in the Bradford Opportunity Area Programme, a Department for Education initiative.  

According to national guidelines, once discharged from hospital, severely premature children are given follow-up medical support, and it is recommended that their schools are informed of their circumstance. However, for moderately premature children, born between three and eight weeks early, there is no routine follow-up support offered, so schools are unlikely to be informed.

While previous studies have found that children born severely premature, more than ten weeks early, are more likely to suffer educational problems, the new research highlights the disadvantage children born moderate-to-late premature may face.

The findings also suggest children born prematurely face disadvantage at an earlier age than previously thought.


Dr Katherine Pettinger, a neonatal doctor from the Born in Bradford study and the Bradford Teaching Hospitals NHS Foundation Trust, who co-authored the research, said, ‘while it seems like an obvious solution, delayed entry for premature children is not likely to compensate for being born early, as we found that within a given school year, the risks to development faced by children born premature did not vary depending on when within that school year they were born.

‘To try to better support this at-risk group we instead suggest that schools should be informed which of their pupils were born prematurely so they can be given extra support, particularly early on in their schooling.’


The researchers also suggest a number of other measures to ensure children born prematurely do not face disadvantage, they include:

  • Providing tailored advice to families of premature children.
  • Ensuring teachers have learning resources to help them support children born prematurely in the classroom.
  • Routine sharing of data between health and education services.

The research is published in the journal Archives of Disease in Childhood and titled ‘Starting School: Educational Development as a Function of Age of Entry and Prematurity’

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