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Gestational Age at Delivery and Special Educational Need: Retrospective Cohort Study of 407,503 Schoolchildren

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  • Daniel F MacKay
  • Gordon C S Smith
  • Richard Dobbie
  • Jill P Pell

Abstract

A retrospective cohort study of 407,503 schoolchildren by Jill Pell and colleagues finds that gestational age at delivery has a dose-dependent relationship with the risk of special educational needs that extends across the full gestational range.Background: Previous studies have demonstrated an association between preterm delivery and increased risk of special educational need (SEN). The aim of our study was to examine the risk of SEN across the full range of gestation. Methods and Findings: We conducted a population-based, retrospective study by linking school census data on the 407,503 eligible school-aged children resident in 19 Scottish Local Authority areas (total population 3.8 million) to their routine birth data. SEN was recorded in 17,784 (4.9%) children; 1,565 (8.4%) of those born preterm and 16,219 (4.7%) of those born at term. The risk of SEN increased across the whole range of gestation from 40 to 24 wk: 37–39 wk adjusted odds ratio (OR) 1.16, 95% confidence interval (CI) 1.12–1.20; 33–36 wk adjusted OR 1.53, 95% CI 1.43–1.63; 28–32 wk adjusted OR 2.66, 95% CI 2.38–2.97; 24–27 wk adjusted OR 6.92, 95% CI 5.58–8.58. There was no interaction between elective versus spontaneous delivery. Overall, gestation at delivery accounted for 10% of the adjusted population attributable fraction of SEN. Because of their high frequency, early term deliveries (37–39 wk) accounted for 5.5% of cases of SEN compared with preterm deliveries (

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  • Daniel F MacKay & Gordon C S Smith & Richard Dobbie & Jill P Pell, 2010. "Gestational Age at Delivery and Special Educational Need: Retrospective Cohort Study of 407,503 Schoolchildren," PLOS Medicine, Public Library of Science, vol. 7(6), pages 1-10, June.
    • Handle: RePEc:plo:pmed00:1000289
    DOI: 10.1371/journal.pmed.1000289
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    Cited by:

    1. Katie Harron & Ruth Gilbert & David Cromwell & Jan van der Meulen, 2016. "Linking Data for Mothers and Babies in De-Identified Electronic Health Data," PLOS ONE, Public Library of Science, vol. 11(10), pages 1-18, October.
    2. David Odd & David Evans & Alan Emond, 2013. "Preterm Birth, Age at School Entry and Educational Performance," PLOS ONE, Public Library of Science, vol. 8(10), pages 1-6, October.

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