Socio-economic achievements of individuals born very preterm at the age of 27 to 29 years: a nationwide cohort study

Aim  To describe the socio economic achievement of individuals born very preterm (VPT) at the age of 27 to 29 years.
Method  Demographic and social data were extracted from national registers for all individuals born between 1974 and 1976 in Denmark ( n =208 656). Of these, 203 283 individuals were alive in 2006. We compared VPT individuals (gestational age <33wks, n =1422; 51.8% males, n =736) with individuals born at term (>36wks, n =192 223; 51.1% males, n =98 240), of whom 4.08% ( n =58) of the VPT and 0.19% ( n =373) of the term individuals had a diagnosis of cerebral palsy (CP).
Results  Overall results in the two groups were similar, but significant differences appeared. The VPT group had a lower educational level than the term group: 23.9% versus 16.3% had a basic education (corresponding to attendance at basic school for 9y or less; odds ratio OR] =1.61, 95% confidence interval CI] 1.42–1.82). Similarly, 31.9% versus 37.6% had a tertiary education (corresponding to different levels of professional education; OR=0.77, CI 0.69–0.86). Net income was 11% lower in the VPT group and 10.8% versus 5.3% were receiving welfare support (OR=2.14, CI 1.81–2.55). In the VPT group 59% versus 52% did not have children ( p <0.001) and there were more individuals living alone without children (28.8% vs 21.8%; OR=1.45, CI 1.29–1.63).
Interpretation  VPT birth in the 1970s in Denmark is associated with a highly statistically significant educational and social disadvantage persisting into young adulthood. CP increased the relative risk of social disadvantage in VPT individuals. However, the majority of the survivors are well integrated in society.