Rapid Fire Australian Epidemiology Association ASM 2018

Effect of small-for-gestational-age on educational outcomes: A linked data study (#152)

Siranda Torvaldsen 1 2 3 , Daneeta Hennessy 4 , Jennifer R Bowen 1 3 5 , Christine L Roberts 1 3 , Jason P Bentley 6 , Jonathan M Morris 1 3
  1. Clinical and Population Perinatal Health Research, University of Sydney, Sydney, NSW, Australia
  2. School of Public Health and Community Medicine, UNSW, Sydney, NSW, Australia
  3. The University of Sydney Northern Clinical School, University of Sydney, Sydney, NSW, Australia
  4. Biostatistics Training Program, NSW Ministry of Health, Sydney, NSW
  5. Department of Neonatology, Royal North Shore Hospital, Sydney, NSW, Australia
  6. Menzies Centre for Health Policy, The University of Sydney School of Public Health, Sydney, NSW

Background: Small-for-gestational-age (SGA) is used as a proxy for intrauterine growth restriction, which is associated with adverse outcomes.

Aims: To determine whether children born SGA have poorer educational outcomes than children who were born not SGA, for gestational ages 24–41 weeks.

Method: A record linkage cohort study of children born in 1994–2005 in NSW, with follow up to 2014. Multiple births were excluded. Linked birth records and standardised educational test (NAPLAN) results were used to compare low numeracy and reading scores (<1SD below mean) and undertake multivariable analyses using robust Poisson generalized estimating equations.

Results/findings: Of 546,993 births that linked to an education record, 11% were SGA. The proportion of children born SGA with low scores was higher than in children born not SGA, at all gestational ages. The proportion with low scores for numeracy and reading decreased with increasing gestational age in both SGA (numeracy: 67% at 24–25 weeks, 20% at 39–41 weeks) and not SGA (numeracy: 47% at 24–25 weeks, 14% at 39–41 weeks) children. After adjusting for confounders, children born SGA were more likely to have low scores than not SGA children at all gestational ages and had an overall increased risk of 31% (95%CI 29%–33%) for numeracy and 25% (95%CI 23%–27%) for reading.

Conclusions: The risk of a poor educational outcome decreases with each increasing week of gestational age and children born SGA are at greater risk than children born not SGA, at all gestational ages.