TIGAR
Research type
Research Study
Full title
Tracking the Impact of Gestational Age on health, educational and economic outcomes: a longitudinal Record linkage study (TIGAR)
IRAS ID
183510
Contact name
Maria Quigley
Contact email
Sponsor organisation
The University of Oxford
Duration of Study in the UK
2 years, 8 months, 16 days
Research summary
Summary of Research
A typical full term pregnancy lasts about 40 weeks and babies born before 37 weeks of pregnancy are classified as preterm or premature. Most premature babies survive and do well in the long term, but as a group they are more likely to have difficulties with their health and development, including special educational needs, and they may not perform as well as their classmates in school tests. Even babies who are born just a few weeks early may have more challenges in childhood compared with those who are born after a full term pregnancy.Studies of the long term effect of premature birth need to be based on many children (at least 100,000) to find out what kinds of challenges premature children may have throughout their life. There have been studies as large as this in the past, but their findings may not be relevant to children born today.
We need a large study to assess the health, school achievement, and costs associated with premature birth in babies born in the UK in the 21st century.
The objectives are to:
• Compare the health and school achievement of children born prematurely with those born after a full term pregnancy.
• Determine whether being born prematurely has a larger impact on children who are socially disadvantaged.
• Measure the costs of prematurity to health and education services.TIGAR will use information about all children born in England during 2005-2006 (about one million). Information on the children will be obtained from: birth records; records of hospital admissions or outpatient visits up to age 10 years; and primary school records (e.g. SATs results, special educational needs). The information from these sources will be linked together by independent organisations, which will make the data completely anonymous before sending it to the TIGAR team for analysis.
Summary of Results
Not all babies are born around their due date. Around 60,000 babies are born every year in the UK before 37 weeks' gestation – this is about 7% of all births. Research aims to continually build on our understanding of the needs of this group of babies throughout their life course. The TIGAR study aimed to understand how being born early might affect a child's health and their progress at school. We wanted to do this to set the scene for future research, which might go on to identify specific support that children who are affected by being born early might need, and build on existing guidelines for monitoring these children developed by NICE.The TIGAR health study followed a million children who were born in England in 2005 or 2006. It explored whether children born early had more hospital admissions up to age 10 years compared with children born at about 40 weeks of pregnancy. We found that hospital admissions in children were more common in those born preterm – the more preterm the child was born, the more likely they were to have hospital admissions. This pattern was observed when looking at hospital admissions at all ages, from children under one year of age to children aged 7-10 years. Infections were the most common reason for hospital admission in preterm and term children of all ages.
The TIGAR school study followed between 7,000 and 12,000 children born in the UK in 2000 or 2001. It compared school ‘SATs’ results (standardised tests) at age 11 and GCSE results at age 16 in children born early with their classmates who were born at 39-41 weeks of pregnancy. The study also looked at how many children had special educational needs (SEN). We found that at age 11 years, children who were born preterm were, on average, more likely to have SEN, and were less likely to achieve the expected standard in English and Mathematics SATs (standardised tests at the end of primary school). However, at age 16 years, when looking at passes in GCSEs (English, Mathematics and overall performance), the differences between the performance of the term and preterm children were smaller than those observed at age 11 years. In particular, those born very preterm (<32 weeks) were less likely to achieve a pass than those born at full term (39-41 weeks). However, children born just a few weeks early (32-36 weeks) had a similar pass rate to those born at full-term.
A lay summary of all of the results on hospital admissions, school results and SEN may be found here
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South West - Frenchay Research Ethics Committee
REC reference
15/SW/0294
Date of REC Opinion
22 Oct 2015
REC opinion
Favourable Opinion