Each year, 15 million babies are born preterm worldwide. Preterm birth is associated with adverse
neurodevelopmental outcomes across the lifespan. Recent registry-based studies suggest that
preterm birth is associated with lower wealth in adulthood, but the mediating mechanisms are
unknown. This study investigated whether the relationship between preterm birth and low adult wealth
is mediated by poor academic abilities and educational qualifications. Participants were members of
two British population-based birth cohorts born in 1958 and 1970. Results showed that preterm birth
was associated with decreased wealth at 42 years of age. This association was mediated by poorer
intelligence, reading and, in particular, mathematics attainment in middle childhood, and lower
educational qualifications in young adulthood. Findings were similar in both cohorts, suggesting that
these mechanisms may be time invariant. Special educational support in childhood may prevent
preterm children from becoming less wealthy as adults
