Obstetric factors and different causes of special educational need: retrospective cohort study of 407,503 schoolchildren.
Objective: To determine whether relationships with gestational age and birthweight centile vary between specific causes of special educational need (SEN).Design: Retrospective cohort study.Setting: Scotland.Population: A cohort of 407,503 schoolchildren.Methods: Polytomous logistic regression was us...
| Published in: | BJOG: An International Journal of Obstetrics & Gynaecology Vol. 120; no. 3; pp. 297 - 309 |
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| Main Authors: | , , , , , , , , , |
| Format: | research Journal Article |
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Wiley-Blackwell
Feb2013
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104294046&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 104294046 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14700328 KJ6 jtl: BJOG: An International Journal of Obstetrics & Gynaecology issn: 14700328 maglogo: Y pubinfo: dt: Feb2013 vid: 120 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 104294046 104294046 NLM23189965 2011898881 10.1111/1471-0528.12071 NLM23189965 104294046 ppf: 297 ppct: 12 formats: tig: atl: Obstetric factors and different causes of special educational need: retrospective cohort study of 407,503 schoolchildren. aug: au: Mackay D Smith G Dobbie R Cooper SA Pell J Mackay, D F Smith, G C S Dobbie, R Cooper, S-A Pell, J P affil: Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK sug: subj: Birth Weight Education, Special Statistics and Numerical Data Fetal Growth Retardation Epidemiology Gestational Age Childbirth, Premature Epidemiology Adolescence Affective Symptoms Epidemiology Affective Symptoms Etiology Child Child Behavior Disorders Epidemiology Child Behavior Disorders Etiology Child, Preschool Children with Disabilities Statistics and Numerical Data Educational Status Female Fetal Growth Retardation Etiology Human Intellectual Disability Epidemiology Intellectual Disability Etiology Auditory Perceptual Disorders Epidemiology Auditory Perceptual Disorders Etiology Childbirth, Premature Etiology Psychomotor Disorders Epidemiology Psychomotor Disorders Etiology Regression Retrospective Design Scotland Sensation Disorders Epidemiology Sensation Disorders Etiology Young Adult Adolescent: 13-18 years Child: 6-12 years Child, Preschool: 2-5 years Female ab: Objective: To determine whether relationships with gestational age and birthweight centile vary between specific causes of special educational need (SEN).Design: Retrospective cohort study.Setting: Scotland.Population: A cohort of 407,503 schoolchildren.Methods: Polytomous logistic regression was used to examine the risk of each cause of SEN across the spectrum of gestation at delivery and birthweight centile, adjusting for potential confounding factors.Main Outcome Measures: Crude and adjusted odds ratios and confidence intervals.Results: Of the 19,821 children with SEN, 557 (2.8%) had sensory impairments, 812 (4.1%) had physical or motor disabilities, 876 (4.4%) had language impairments, 2823 (14.2%) had social, emotional, or behavioural problems, 7018 (35.4%) had intellectual disabilities, 4404 (22.2%) had specific learning difficulties, and 1684 (8.5%) autistic spectrum disorder (ASD). Extreme preterm delivery (at 24-27 weeks of gestation) was a strong predictor of sensory (adjusted OR 23.64, 95% CI 12.03-46.45), physical or motor (adjusted OR 29.69, 95% CI 17.49-50.40), and intellectual (adjusted OR 11.67, 95% CI 8.46-16.10) impairments, with dose relationships across the range of gestation. Similarly, birthweight below the third centile was associated with sensory (adjusted OR 2.85, 95% CI 2.04-3.99), physical or motor (adjusted OR 2.47, 95% CI 1.82-3.37), and intellectual (adjusted OR 2.67, 95% CI 2.41-2.96) impairments. Together, gestation and birthweight centile accounted for 24.0% of SEN arising from sensory impairment, 34.3% arising from physical or motor disabilities, and 26.6% arising from intellectual disabilities. Obstetric factors were less strongly associated with specific learning difficulties and social or emotional problems, and there were no significant associations with ASD.Conclusions: The association between gestation and birthweight centile and overall risk of SEN is largely driven by very strong associations with sensory, physical or motor impairments, and intellectual impairments. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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