Does neighborhood deprivation modify the effect of preterm birth on children's first grade academic performance?

Jennifer L. Richards, Theresa Chapple-McGruder, Bryan L. Williams, Michael R. Kramer

Research output: Contribution to journalArticlepeer-review

22 Scopus citations


Children's cognitive development and academic performance are linked to both fetal and early childhood factors, including preterm birth and family socioeconomic status. We evaluated whether the relationship between preterm birth (PTB) and first grade standardized test performance among Georgia public school students was modified by neighborhood deprivation in early childhood.The Georgia Birth to School cohort followed 327,698 children born in Georgia from 1998 to 2002 through to end-of-year first grade standardized tests. Binomial and log-binomial generalized estimating equations were used to estimate risk differences and risk ratios for the associations of both PTB and the Neighborhood Deprivation Index for the census tract in which each child's mother resided at the time of birth with test failure (versus passing). The presence of additive and multiplicative interaction was assessed.PTB was strongly associated with test failure, with increasing risk for earlier gestational ages. There was positive additive interaction between PTB and neighborhood deprivation. The main effect of PTB versus term birth increased risk of mathematics failure: 15.9% (95%CI: 13.3-18.5%) for early, 5.0% (95% CI: 4.1-5.9%) for moderate, and 1.3% (95%CI: 0.9-1.7%) for late preterm. Each 1 standard deviation increase in neighborhood deprivation was associated with 0.6% increased risk of mathematics failure. For children exposed to both PTB and higher neighborhood deprivation, test failure was 4.8%, 1.5%, and 0.8% greater than the sum of two main effects for early, moderate, and late PTB, respectively. Results were similar, but slightly attenuated, for reading and English/language arts.Our results suggest that PTB and neighborhood deprivation additively interact to produce greater risk among doubly exposed children than would be predicted from the sum of the effects of the two exposures. Understanding socioeconomic disparities in the effect of PTB on academic outcomes at school entry is important for targeting of early childhood interventions.

Original languageEnglish (US)
Pages (from-to)122-131
Number of pages10
JournalSocial Science and Medicine
StatePublished - May 1 2015
Externally publishedYes


  • Academic achievement
  • Interaction
  • Neighborhood deprivation
  • Preterm birth
  • Socioeconomic status

ASJC Scopus subject areas

  • Health(social science)
  • History and Philosophy of Science


Dive into the research topics of 'Does neighborhood deprivation modify the effect of preterm birth on children's first grade academic performance?'. Together they form a unique fingerprint.

Cite this