Spatial Skills in Children Born Preterm: A Meta-Analysis

Spatial skills refer to the ability to orient oneself in space and to interpret and reason about relationships between objects in space. Beyond day-to-day functioning, they play a role in success in Science, Technology, Engineering and Mathematics (STEM). Children born preterm often show weaker spatial skills than term-born peers, but findings across individual studies have not previously been synthesised. This meta-analysis quantified differences in spatial skills between these two groups. 62 case-control studies were included, comprising 9,325 participants (preterm n = 5,146; term-born n = 4,179) aged between 3 and 202 months across 21 countries reporting 165 effect sizes. A medium effect was observed for the difference in performance on spatial skill tasks between preterm and term-born participants ( g = −.489, SE = .0368). Degree of prematurity significantly moderated this effect, with a graded increase in the magnitude of difference as prematurity increased; extremely preterm ( g = −.658, SE = .084), very preterm ( g = −.447, SE = .096), and moderate-to-late preterm ( g = −.335, SE = .105). Neither age, gender nor spatial skill type (i.e., intrinsic, extrinsic, spatial memory) yielded a statistically significant result. Overall, results of the present review indicate that preterm birth is associated with weaker spatial skills when compared to term-born peers, with the magnitude of this difference increasing with greater prematurity. This difference is evident in both males and females and persists with age. These findings clarify the magnitude of spatial skill differences following preterm birth and may inform targeted educational supports to promote later academic outcomes.