Skip to main content Accessibility help

How do childhood intelligence and early psychosocial adversity influence income attainment among adult extremely low birth weight survivors? A test of the cognitive reserve hypothesis

  • Kathleen G. Dobson (a1) (a2), Mark A. Ferro (a3), Michael H. Boyle (a1), Louis A. Schmidt (a1), Saroj Saigal (a1) and Ryan J. Van Lieshout (a1)...


Perinatal and later postnatal adversities have been shown to adversely affect socioeconomic trajectories, while enhanced early cognitive abilities improve them. However, little is known about the combined influence of these exposures on social mobility. In this study, we examined if childhood IQ moderated the association between four different types of postnatal adversity (childhood socioeconomic disadvantage, childhood sexual abuse, lifetime psychiatric disorder, and trait neuroticism) and annual earnings at 30–35 years of age in a sample of 88 extremely low birth weight survivors. Our results suggested that higher childhood IQ was associated with greater personal income at age 30–35. Extremely low birth weight survivors who did not face psychological adversities and who had higher childhood IQ reported higher income in adulthood. However, those who faced psychological adversity and had higher childhood IQ generally reported lower income in adulthood. Our findings suggest that cognitive reserve may not protect preterm survivors against the complex web of risk factors affecting their later socioeconomic attainment.


Corresponding author

Address correspondence and reprint requests to: Kathleen G. Dobson, Women's Health Concerns Clinic, St. Joseph's Hospital Hamilton, West 5th Campus, Room C142, 100 West 5th Street, Hamilton, Ontario L8N 3K7, Canada; E-mail:


Hide All

We thank the participants and families for participating in the study and Kimberly Day for her help with data preparation. This research was supported by Canadian Institutes of Health Research Team Grant 103145. The authors have no conflict of interest.



Hide All
Allin, M., Rooney, M., Cuddy, M., Wyatt, J., Walshe, M., Rifkin, L., & Murray, R. (2006). Personality in young adults who are born preterm. Pediatrics, 117, 309316. doi:10.1542/peds.2005-0539
Almond, D., & Currie, J. (2011). Killing me softly: The fetal origins hypothesis. Journal of Economic Perspectives, 25, 153172. doi:10.1257/jep.25.3.153
Anderson, L. M., Shinn, C., Fullilove, M. T., Scrimshaw, S. C., Fielding, J. E., Normand, J., … Task Force on Community Preventive Services. (2003). The effectiveness of early childhood development programs: A systematic review. American Journal of Preventive Medicine, 24(Suppl. 3), 3246. doi:10.1016/S0749-3797(02)00655-4
Arnett, J. J. (2000). Emerging adulthood: A theory of development from the late teens through the twenties. American Psychologist, 55, 469480. doi:10.1037//0003-066X.55.5.469
Bair-Merritt, M. H., Mandal, M., Garg, A., & Cheng, T. L. (2015). Addressing psychosocial adversity within the patient-centered medical home: Expert-created measurable standards. Journal of Primary Prevention, 36, 213225. doi:10.1007/s10935-015-0390-7
Basten, M., Jaekel, J., Johnson, S., Gilmore, C., & Wolke, D. (2015). Preterm birth and adult wealth: Mathematics skills count. Psychological Science, 26, 16081619. doi:10.1177/0956797615596230
Blanden, J., Gregg, P., & Macmillan, L. (2007). Accounting for intergenerational income persistence: Noncognitive skills, ability, and education (No. 2554). Bonn, Germany: IZA Discussion Papers.
Blencowe, H., Cousens, S., Oestergaard, M. Z., Chou, D., Moller, A. B., Narwal, R., … Lawn, J. E. (2012). National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: A systematic analysis and implications. Lancet, 379, 21622172. doi:10.1016/S0140-6736(12)60820-4
Boyle, M. H., Offord, D. R., Hofmann, H. G., Catlin, G. P., Byles, J. A., Cadman, D. T., … Szatmari, P. (1987). Ontario Child Health Study: I. Methodology. Archives of General Psychiatry, 44, 826831. doi:10.1001/archpsyc.1987.01800210078012
Breslau, J., Lane, M., Sampson, N., & Kessler, R. C. (2008). Mental disorders and subsequent educational attainment in a US national sample. Journal of Psychiatric Research, 42, 708716. doi:10.1016/j.jpsychires.2008.01.016
Caspi, A., & Roberts, B. W. (2001). Personality development across the life course: The argument for change and continuity. Psychological Inquiry, 12, 4966. doi:10.1207/S15327965PLI1202_01
Ceci, S. J., & Williams, W. M. (1997). Schooling, intelligence, and income. American Psychologist, 52, 10511058. doi:10.1037/0003-066X.52.10.1051
Coleman, J. (1966). Equity of educational opportunity. Washington, DC: US Government Printing Office.
Conger, R. D., & Donnellan, M. B. (2007). An interactionist perspective on the socioeconomic context of human development. Annual Review of Psychology, 58, 175199. doi:10.1146/annurev.psych.58.110405.085551
Cook, J. C., & Fletcher, J. M. (2015). Understanding heterogeneity in the effects of birth weight on adult cognition and wages. Journal of Health Economics, 41, 107116. doi:10.1016/j.jhealeco.2015.01.005
Cosentino, S., & Stern, Y. (2012). Consideration of cognitive reserve. In Ravdin, L. D. & Kazden, H. L. (Eds.), Handbook on the neuropsychology of aging and dementia (pp. 1123). New York: Springer.
Covin, T. M. (1977). Stability of the WISC-R for 9-year-olds with learning difficulties. Psychological Reports, 40, 12971298.
Currie, J. (2008). Healthy, wealthy, and wise: Socioeconomic status, poor health in childhood, and human capital development (NBER Working Paper 13987). Cambridge, MA: National Bureau of Economic Research.
Deary, I. J., & Batty, G. D. (2007). Cognitive epidemiology. Journal of Epidemiology and Community Health, 61, 378384. doi:10.1136/jech.2005.039206
Diez-Roux, A. V., Link, B. G., & Northridge, M. E. (2000). A multilevel analysis of income inequality and cardiovascular disease risk factors. Social Science & Medicine, 50, 673687. doi:10.1016/S0277-9536(99)00320-2
Doyle, L. W., & Anderson, P. J. (2010). Adult outcome of extremely preterm infants. Pediatrics, 126, 342351. doi:10.1542/peds.2010-0710
Dubow, E. F., Boxer, P., & Huesmann, L. R. (2009). Long-term effects of parents’ education on children's educational and occupational success: Mediation by family interactions, child aggression, and teenage aspirations. Merrill-Palmer Quarterly, 55, 224249. doi:10.1353/mpq.0.0030
Eryigit Madzwamuse, S., Baumann, N., Jaekel, J., Bartmann, P., & Wolke, D. (2015). Neuro-cognitive performance of very preterm or very low birth weight adults at 26 years. Journal of Child Psychology and Psychiatry, 56, 857864. doi:10.1111/jcpp.12358
Eysenck, S. B. G., Eysenck, H. J., & Barrett, P. (1985). A revised version of the psychoticism scale. Personality and Individual Differences, 6, 2129. doi:10.1016/0191-8869(85)90026-1
Hack, M., Taylor, H. G., Klein, N., Eiben, R., Schatschneider, C., & Mercuri-Minich, N. (1994). School-age outcomes in children with birth weights under 750 g. New England Journal of Medicine, 331, 753759. doi:10.1056/nejm199409223311201
Heinonen, K., Eriksson, J. G., Kajantie, E., Pesonen, A. K., Barker, D. J., Osmond, C., & Raikkonen, K. (2013). Late-preterm birth and lifetime socioeconomic attainments: The Helsiniki birth cohort. Pediatrics, 132, 647655. doi:10.1542/peds.2013-0951
Herd, P., Carr, D., & Roan, C. (2014). Cohort profile: Wisconsin Longitudinal Study (WLS). International Journal of Epidemiology, 43, 3441. doi:10.1093/ije/dys194
Hollingshead, A. (1969). Two Factor Index of Social Position. New Haven, CT: Yale University Press.
Irwin, D. O. (1966). Reliability of the Wechsler Intelligence Scale for Children. Journal of Educational Measurement, 3, 287292. doi:10.1111/j.1745-3984.1966.tb00891.x
Jiménez-Jiménez, F. J., Alonso-Navarro, H., García-Martín, E., & Agúndez, J. A. (2014). COMT gene and risk for Parkinson's disease: A systematic review and meta-analysis. Pharmacogenetics and Genomics, 24, 331339. doi:10.1097/FPC.0000000000000056
Johnston, D., Propper, C., Pudney, S., & Shields, M. (2014). Child mental health and educational attainment: Multiple observers and the measurement error problem. Journal of Applied Econometrics, 29, 880900 doi:10.1002/jae.2359
Judge, T. A., & Ilies, R. (2002). Relationship of personality to performance motivation: A meta-analytic review. Journal of Applied Psychology, 87, 797807. doi:10.1037//0021-9010.87.4.797
Judge, T., Klinger, R. L., & Simon, L. (2010). Time is on my side: Time, general mental ability, human capital, and extrinsic career success. Journal of Applied Psychology, 95, 92107. doi:10.1037/a0017594
Kessler, R. C., Amminger, G. P., Aguilar-Gaziola, S., Alonso, J., Lee, S., & Űstűn, T. B. (2007). Age of onset of mental disorders: A review of recent literature. Current Opinion in Psychiatry, 20, 359364. doi:10.1097/YCO.0b013e32816ebc8c
Kramer, M. S. (1987). Determinants of low birth weight: Methodological assessment and meta-analysis. Bulletin of the World Health Organization, 65, 663737.
Kuban, K. C. K., Joseph, R. M., O'Shea, T. M., Allred, E. N., Heeren, T., Douglass, L., … Extremely Low Gestational Age Newborn (ELGAN) Study Investigators. (2016). Girls and boys born before 28 weeks gestation: Risks of cognitive, behavioral, and neurologic outcomes at age 10 years. Journal of Pediatrics, 173, 6975. doi:10.1016/j.jpeds.2016.02.048
Macmillan, R. (2000). Adolescent victimization and income deficits in adulthood: Rethinking the costs of criminal violence from a life-course perspective. Criminology, 38, 553588. doi:10.1111/j.1745-9125.2000.tb00899.x
Macmillan, R. (2001). Violence and the life course: The consequences of victimization for personal and social development. Annual Review of Sociology, 27, 122. doi:10.1146/annurev.soc.27.1.1
Macmillan, R., & Hagan, J. (2004). Violence in the transition to adulthood: Adolescent victimization, education, and socioeconomic attainment in later life. Journal of Research on Adolescence, 14, 127158. doi:10.1111/j.1532-7795.2004.01402001.x
Manley, B. J., Roberts, R. S., Doyle, L. W., Schmidt, B., Anderson, P. J., Barrington, K. J., … Caffeine for Apnea of Prematurity CAP Trial Investigators. (2015). Social variables predict gains in cognitive scores across the preschool years in children with birth weights 500 to 1250 grams. Journal of Pediatrics, 166, 870876.e2. doi:10.1016/j.jpeds.2014.12.016
Maritim, A. C., Sanders, R. A., & Watkins, J. B. (2003). Diabetes, oxidative stress, and antioxidants: A review. Journal of Biochemical and Molecular Toxicology, 17, 2438. doi:10.1002/jbt.10058
Mathewson, K. J., Chow, C. H. T., Dobson, K. G., Pope, E. I., Schmidt, L. A., & Van Lieshout, R. J. (2017). Mental health of extremely low birth weight survivors: A systematic review and meta-analysis. Psychological Bulletin, 143, 347383. doi:10.1037/bul0000091
Milojev, P., & Sibley, C. G. (2014). The stability of adult personality varies across age: Evidence from a two-year longitudinal sample of adult New Zealanders. Journal of Research in Personality, 51, 2937. doi:10.1016/j.jrp.2014.04.005
Moster, D., Lie, R. T., & Markestad, T. (2008). Long-term medical and social consequences of preterm birth. New England Journal of Medicine, 359, 262273. doi:10.1056/nejmoa0706475
Murphy, S. L., Mathews, T. J., Martin, J. A., Minkovitz, C. S., & Strobino, D. M. (2017). Annual summary of vital statistics: 2013–2014. Pediatrics, 139, e20163239. doi:10.1542/peds.2016-3239
Ng, T. W. H., Eby, L. T., Sorensen, K. L., & Feldman, D. C. (2005). Predictors of objective and subjective career success: A meta-analysis. Personnel Psychology, 58, 367408.
Osler, M., Prescott, E., Grønbæk, M., Christensen, U., Due, P., & Engholm, G. (2002). Income inequality, individual income, and mortality in Danish adults: Analysis of pooled data from two cohort studies. British Medical Journal, 324, 13. doi:10.1136/bmj.324.7328.13
Power, C., Stansfeld, S. A., Matthews, S., Manor, O., & Hope, S. (2002). Childhood and adulthood risk factors for socio-economic differentials in psychological distress: Evidence from the 1958 British birth cohort. Social Science and Medicine, 55, 19892004. doi:10.1016/S0277-9536(01)00325-2
Preacher, K. J., Curran, P. J., & Bauer, D. J. (2006). Computational tools for probing interactions in multiple linear regression, multilevel modeling, and latent curve analysis. Journal of Educational and Behavioral Statistics, 31, 437448. doi:10.3102/10769986031004437
Reuben, A., Moffitt, T. E., Caspi, A., Belsky, D. W., Harrington, H., Schroeder, F., … Danese, A. (2016). Lest we forget: Comparing retrospective and prospective assessments of adverse childhood experiences in the prediction of adult health. Journal of Child Psychology and Psychiatry, 57, 11031112. doi:10.1111/jcpp.12621
Roy, A. (2002). Childhood trauma and neuroticism as an adult: Possible implication for the development of the common psychiatric disorders and suicidal behaviour. Psychological Medicine, 32, 14711474. doi:10.1017/S0033291702006566
Saigal, S. (2014). Functional outcomes of very premature infants into adulthood. Seminars in Fetal and Neonatal Medicine, 19, 125130. doi:10.1016/j.siny.2013.11.001
Saigal, S., Day, K. L., Van Lieshout, R. J., Schmidt, L. A., Morrison, K. M., & Boyle, M. H. (2016). Health, wealth, social integration, and sexuality of extremely low-birth-weight prematurely born adults in the fourth decade of life. JAMA Pediatrics, 170, 678686. doi:10.1001/jamapediatrics.2016.0289
Saigal, S., Szatmari, P., Rosenbaum, P., Campbell, D., & King, S. (1991). Cognitive abilities and school performance of extremely low birth weight children and matched term control children at age 8 years: A regional study. Journal of Pediatrics, 118, 751760.
Sareen, J., Afifi, T. O., McMillan, K. A., & Asmundson, G. J. G. (2011). Relationship between household income and mental disorders. Archives of General Psychiatry, 68, 419427. doi:10.1001/archgenpsychiatry.2011.15
Schofield, T. J., Martin, M. J., Conger, K. J., Neppl, T. M., Donnellan, M. B., & Conger, R. D. (2011). Intergenerational transmission of adaptive functioning: A test of the interactionist model of SES and human development. Child Development, 82, 3347. doi:10.1111/j.1467-8624.2010.01539.x
Sheehan, D. V, Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., … Dunbar, G. C. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59(Suppl. 20), 2233 (quizzes 34–57).
Statistics Canada. (2015). Individuals by total income level, by province and territory. Retrieved April 4, 2016, from
Stern, Y. (2003). The concept of cognitive reserve: A catalyst for research. Journal of Clinical and Experimental Neuropsychology, 25, 589593.
Strenze, T. (2007). Intelligence and socioeconomic success: A meta-analytic review of longitudinal research. Intelligence, 35, 401426. doi:10.1016/j.intell.2006.09.004
Tanaka, M., Wekerle, C., Leung, E., Waechter, R., Gonzalez, A., Jamieson, E., & MacMillan, H. L. (2012). Preliminary evaluation of the Childhood Experiences of Violence Questionnaire Short Form. Journal of Interpersonal Violence, 27, 396407. doi:10.1177/0886260511416462
Turner, R. H. (1960). Sponsored and contest mobility and the school system. American Sociological Review, 25, 855867.
United Nations Children's Fund and World Health Organization. (2004). Low birthweight: Country, regional and global estimates. New York: UNICEF.
Valero De Bernabé, J., Soriano, T., Albaladejo, R., Juarranz, M., Calle, M. E., Martínez, D., & Dominguez-Rojas, V. (2004). Risk factors for low birth weight: A review. European Journal of Obstetrics Gynecology and Reproductive Biology, 116, 315. doi:10.1016/j.ejogrb.2004.03.007
Van Lieshout, R. J., Boyle, M. H., Saigal, S., Morrison, K., & Schmidt, L. A. (2015). Mental health of extremely low birth weight survivors in their 30s. Pediatrics, 135, 452459. doi:10.1542/peds.2014-3143
Walker, D., Greenwood, C., Hart, B., & Carta, J. (1994). Prediction of school outcomes based on early language production and socioeconomic factors. Child Development, 65, 606621.
Walsh, C. A., MacMillan, H. L., Trocmé, N., Jamieson, E., & Boyle, M. H. (2008). Measurement of victimization in adolescence: Development and validation of the Childhood Experiences of Violence Questionnaire. Child Abuse and Neglect, 32, 10371057. doi:10.1016/j.chiabu.2008.05.003
Waxman, J., Van Lieshout, R. J., Saigal, S., Boyle, M. H., & Schmidt, L. A. (2013). Still cautious: Personality characteristics of extremely low birth weight adults in their early 30s. Personality and Individual Differences, 55, 967971. doi:10.1016/j.paid.2013.08.003
Wechsler, D. (1974). Manual for the Wechsler Intelligence Scale for Children (rev.). New York: Psychological Corporation.
Whitfield, M. F., Grunau, R. V. E., & Holsti, L. (1997). Extremely premature (<800 g) schoolchildren: Multiple areas of hidden disability. Archives of Disease in Childhood. Fetal and Neonatal Edition, 77, F85F90. doi:10.1136/fn.77.2.F85
Zielinski, D. S. (2009). Child maltreatment and adult socioeconomic well-being. Child Abuse and Neglect, 33, 666678. doi:10.1016/j.chiabu.2009.09.001
Type Description Title
Supplementary materials

Dobson et al supplementary material

 Word (29 KB)
29 KB


Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed