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Born Small for Gestational Age and Poor School Performance - How Small Is Too Small?

Linda Lindström1, Anna-Karin Wikström2,3, Eva Bergman1

  • 1Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.

Hormone Research in Paediatrics
|July 12, 2017
PubMed

Insights

Children born small for gestational age (SGA) face a higher risk of poor school performance, with the risk escalating with SGA severity. Adult stature may influence this association.

Area of Science:

  • Pediatric Health
  • Developmental Pediatrics
  • Educational Psychology

Background:

  • Small for gestational age (SGA) is a condition where infants are born smaller than expected for their gestational age.
  • SGA is associated with various short- and long-term health risks, including potential developmental and academic challenges.
  • Understanding the long-term academic consequences of SGA is crucial for early intervention and support.

Purpose of the Study:

  • To examine the association between the severity of small for gestational age (SGA) and the likelihood of poor school performance.
  • To investigate if adult stature modifies the relationship between SGA and school performance.

Main Methods:

  • A large cohort study of 1,088,980 Swedish children born at term (1973-1988).
  • Children were categorized into SGA severity groups (severe, moderate, mild) based on birth weight standard deviations.
  • Poor school performance was defined as grades in the bottom 10th percentile at compulsory school graduation; logistic regression models were used for analysis, adjusting for socio-economic factors and adult stature in sub-analyses.

Main Results:

  • All small for gestational age (SGA) groups demonstrated a significantly increased risk of poor school performance compared to appropriate for gestational age peers.
  • Adjusted odds ratios for poor school performance ranged from 1.85 for severe SGA to 1.25 for mild SGA.
  • In boys, short adult stature was associated with a higher risk of poor school performance across all birth weight groups.

Conclusions:

  • A significant association exists between mild small for gestational age (SGA) and increased risk of poor school performance, with risk increasing with SGA severity.
  • The findings suggest that SGA, even in its milder forms, can impact academic outcomes.
  • Adult stature appears to be a modifying factor in the relationship between SGA and school performance, particularly in boys.
Abstract

Keywords:
Catch-up growthCognitive developmentIntrauterine growthSmall for gestational ageStature

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