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Association between small-for-gestational age and poor school performance in 2 500 000 children born 1973-2002

Alva Gustafsson1, Anna Bonnevier2,3, Karin Källén3

  • 1Department of Obstetrics and Gynecology, Ystad Hospital, Ystad, Sweden.

Acta Paediatrica (Oslo, Norway : 1992)
|November 11, 2023
PubMed

Insights

Infants born small-for-gestational age (SGA) face a higher risk of poor school performance and needing special education. Maternal height influences this association, indicating its importance in assessing SGA impacts.

Area of Science:

  • Pediatrics
  • Educational Psychology
  • Public Health

Background:

  • Birth weight for gestational age is a critical indicator of infant health.
  • Small-for-gestational age (SGA) birth is associated with various developmental challenges.
  • Understanding long-term outcomes of SGA is crucial for early intervention.

Purpose of the Study:

  • To investigate the association between infant weight for gestational age and school performance at age 16.
  • To determine if being born small-for-gestational age (SGA) impacts educational attainment.
  • To explore potential modifying factors, such as maternal height, in this relationship.

Main Methods:

  • Utilized the Swedish Medical Birth Register to identify infants born near- or at-term between 1973-2002.
  • Analyzed data from 2,525,571 infants, with 65,912 identified as SGA.
  • Employed modified Poisson and weighted linear regression analyses to assess risks for special school placement and final grades.

Main Results:

  • Small-for-gestational age (SGA) was significantly associated with an increased need for special school (RR 2.25-2.47).
  • SGA was also linked to lower final school grades (RR 1.18-1.49 for grades below 10th/25th percentile).
  • A linear relationship between maternal height and the risk of special school placement was observed, suggesting SGA's impact is more pronounced in children of taller mothers.

Conclusions:

  • Small-for-gestational age (SGA) is a significant risk factor for poorer school performance and the need for special education.
  • Maternal height appears to modify the association between SGA and school outcomes.
  • Considering maternal height is important for a comprehensive assessment of SGA's long-term effects on academic achievement.
Abstract

Keywords:
foetal growth restrictionlarge for gestational ageschool performancesmall-for-gestational agespecial needs school

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