Abstract
Objective: To estimate the association between small for gestational age (SGA) at birth and educational performance on standardized testing and disability prevalence in elementary and middle school. Study design: Through linked birth certificates and school records, surviving infants born at 23-41 weeks of gestation who entered Florida's public schools 1998-2009 were identified. Twenty-three SGA definitions (3rd-25th percentile) were derived. Outcomes were scores on Florida Comprehensive Assessment Test (FCAT) and students' disability classification in grades 3 through 8. A “sibling cohort” subsample included families with at least 2 siblings from the same mother in the study period. Multivariable models estimated independent relationships between SGA and outcomes. Results: Birth certificates for 80.2% of singleton infants were matched to Florida public school records (N = 1 254 390). Unadjusted mean FCAT scores were 0.236 SD lower among <10th percentile SGA infants compared with non-SGA infants; this difference declined to −0.086 SD after adjusting for maternal and infant characteristics. When siblings discordant in SGA status were compared within individual families, the association declined to −0.056 SD. For SGA <10th percentile infants, the observed prevalence of school-age disability was 15.0%, 7.7%, and 6.3% for unadjusted, demographics-adjusted, and sibling analyses, respectively. No inflection or discontinuity was detected across SGA definitions from 3rd to 25th percentile in either outcome, and the associations were qualitatively similar. Conclusions: The associations between SGA birth and students' standardized test scores and well-being were quantitatively small but persisted through elementary and middle school. The observed deficits were largely mitigated by demographic and familial factors.
Original language | English (US) |
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Pages (from-to) | 159-165.e7 |
Journal | journal of pediatrics |
Volume | 212 |
DOIs | |
State | Published - Sep 2019 |
Funding
Supported by the National Science Foundation (0338740 [to D.F. and J.R.]), the U.S. Department of Education (R305C120008 [to D.F.]), and the Bill and Melinda Gates Foundation through the National Center for the Analysis of Longitudinal Data in Education Research (OPP1029884 [to D.F. and J.R.]). The authors declare no conflicts of interest. We thank the Florida Department of Health and Florida Department of Education for providing us access to de-identified health and education data for the purposes of this project and for the technical support in interpreting the key variables. Supported by the National Science Foundation (0338740 [to D.F. and J.R.]), the U.S. Department of Education (R305C120008 [to D.F.]), and the Bill and Melinda Gates Foundation through the National Center for the Analysis of Longitudinal Data in Education Research (OPP1029884 [to D.F. and J.R.]). The authors declare no conflicts of interest. Supported by the National Science Foundation (0338740 [to D.F. and J.R.]), the U.S. Department of Education (R305C120008 [to D.F.]), and the Bill and Melinda Gates Foundation through the National Center for the Analysis of Longitudinal Data in Education Research (OPP1029884 [to D.F. and J.R.]). The authors declare no conflicts of interest. We thank the Florida Department of Health and Florida Department of Education for providing us access to de-identified health and education data for the purposes of this project and for the technical support in interpreting the key variables. Supported by the National Science Foundation (0338740 [to D.F. and J.R.]), the U.S. Department of Education (R305C120008 [to D.F.]), and the Bill and Melinda Gates Foundation through the National Center for the Analysis of Longitudinal Data in Education Research (OPP1029884 [to D.F. and J.R.]). The authors declare no conflicts of interest.
Keywords
- SGA
- child development
- longitudinal data
- test scores
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health