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

• Aim: To assess the relationship between severity of small for gestational age (SGA) and risk of poor school performance, and to investigate whether adult stature modifies this risk.Methods: 1,088,980 term Swedish children born 1973-1988 were categorized into severe SGA (<-3 standard deviations (SD) of expected birth weight), moderate SGA (-2.01 to -3 SD), mild SGA (-1.01 to -2 SD) and appropriate for gestational age (-1 to 0.99 SD). Risk of poor school performance at time of graduating from compulsory school (grades <10th percentile) was calculated using unconditional logistic regression models and adjusted for socioeconomic factors. In a sub-analysis, we stratified boys by adult stature, and adjusted for maternal but not paternal height.Results: All SGA groups were significantly associated with increased risk of poor school performance, with adjusted odds ratios (aOR) and 95% confidence intervals (CI) ranging from 1.85 (1.65-2.07) for severe SGA to 1.25 (1.22-1.28) for mild SGA. In the sub-analysis, all birth weight groups were associated with increased risk of poor school performance among boys with short staturecompared with non-short stature.Conclusion: Mild SGA is associated with significantly increased risk of poor school performance, and the risk increases with severity of SGA. Further, this risk diminishes after adequate catch-up growth.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Reproduktionsmedicin och gynekologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Obstetrics, Gynaecology and Reproductive Medicine (hsv//eng)

Nyckelord

Small for gestational age

intrauterine growth

cognitive development

catch-up growth

stature

Publikations- och innehållstyp

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