PEDIATRICS Vol. 108 No. 1 July 2001, pp. 111-115
School Difficulties in 20-Year-Olds Who Were Born Small for Gestational Age at Term in a Regional Cohort Study
Received Jul 10, 2000; accepted Nov 9, 2000.
, and
From the * INSERM U149, Villejuif; and Objective. To investigate the
relation between school difficulties and being born small for
gestational age (SGA) at full term in adolescents and young adults.
Methods. A total of 236 full-term singletons who were born
SGA (birth weight and/or length below the third percentile) from 1971 through 1978 and 281 full-term singletons who were born appropriate for gestational age (AGA; between the 25th and 75th percentiles) from the
maternity registry of Haguenau, France. Participants were evaluated at
a mean age of 20.6 (±2.1) years. The outcomes measured were late entry
into secondary school (normal age: 11 years) and failure to take or
pass the baccalaureate examination at the end of secondary school
(normal age: 18 years).
Results. Late entry into secondary school was more
frequent for the SGA than the AGA children (odds ratio: 2.3) after
adjustment for maternal age and educational level, parental
socioeconomic status, family size, and gender. A significantly higher
proportion of term SGA adolescents failed to take or pass the
baccalaureate examination than AGA adolescents (odds ratio: 1.6). SGA
participants with a smaller head circumference entered secondary school
late more often than SGA participants with a larger head circumference, but the association was not significant after adjustment.
Conclusion. Being born SGA at term is associated with
poorer school performance at 12 and 18 years. Fetal adaptation to
conditions that retard growth during gestation may not be successful in
maintaining brain development.
Paediatric
Endocrinology and Diabetes Unit, Hôpital Robert Debré,
Paris, France.
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