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Small-for-Gestational-Age and Vocabulary and Achievement Test Scores at Age 9 Among Children Born at Term in a
Nancy E Reichman1,2,3, Hope Corman4,5, Kelly Noonan6
1Division of Population Health, Quality, and Implementation Science, Department of Pediatrics, Robert Wood Johnson Medical School, Rutgers University, New Brunswick, NJ, USA. reichmne@rwjms.rutgers.edu.
Insights
Children born small-for-gestational-age (SGA) at term may face cognitive challenges. Early interventions are recommended for these children to improve school performance.
Area of Science:
- Pediatric Health
- Developmental Psychology
- Public Health
Background:
- Children born small-for-gestational-age (SGA) exhibit increased risk for cognitive impairment, even at term gestation.
- This study investigates the link between sex-specific SGA and cognitive outcomes in 9-year-old children.
Purpose of the Study:
- To examine the association between small-for-gestational-age (SGA) status and cognitive test performance in term-born children.
- To provide evidence from a contemporary, high-risk US population sample.
Main Methods:
- Secondary data analysis of 2144 term-born children from a US birth cohort study (1998-2000).
- Oversampling of non-marital births to include socioeconomically disadvantaged and minority populations.
- Vocabulary and achievement tests administered at age 9; regression models used to assess SGA associations.
Main Results:
- Sex-specific SGA was linked to 2-5 point lower test scores and increased odds of scores below 85 (more than 1 SD below the mean).
- Adjusted models showed SGA associated with lower scores on Woodcock-Johnson Applied Problems (OR 2.257) and Passage Comprehension (OR 1.554) tests.
Conclusions:
- Findings confirm previous research on SGA and cognitive outcomes in term-born children.
- This study adds evidence from a contemporary, high-risk US population.
- Recommends early intervention for term-born SGA children to enhance cognitive function in school.
Introduction:
Children that are small-for-gestational-age (SGA) at birth are at an increased risk for cognitive impairment, even if born at term (37-41 weeks). This study examined associations between sex-specific SGA and vocabulary and achievement tests in 9 year old children born at term using a contemporary population-based US sample.
Methods:
A secondary data analysis was conducted on a sample of 2144 children born at term in 1998-2000 who participated in a US birth cohort study that oversampled non-marital births, which in the U.S. are associated with socioeconomic disadvantage and racial minority status. Vocabulary and achievement tests were administered to participants at age 9. Unadjusted and adjusted Ordinary Least Squares and logistic regression models of associations between SGA and test scores were estimated.
Results:
Sex-specific SGA was associated with 2-5 point lower test scores and 1-2 times the odds of scores less than 85 (> 1 SD below the national mean) across most outcomes. In adjusted models, measures of SGA were associated with low scores on the Woodcock-Johnson Applied Problems test (OR 2.257; 95% CI 1.434, 3.551) and the Woodcock-Johnson Passage Comprehension test (OR 1.554; 95% CI 1.132, 2.134).
Conclusion:
The findings validate previous studies of SGA at term and cognitive outcomes and provide further evidence using a contemporary high-risk population-based US sample. The findings suggest that SGA children born at term should be recruited for early interventions to promote improved cognitive functioning in school.
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