Affiliation:
1. Population Health Sciences Institute, Faculty of Medical Sciences Newcastle University Newcastle upon Tyne UK
2. Population Health Research Institute St George's, University of London London UK
3. NIHR GOSH Biomedical Research Centre UCL Great Ormond Street Institute of Child Health London UK
4. Faculty of Life and Health Sciences Ulster University Belfast UK
5. Center for Clinical and Epidemiological Research University of Ferrara Ferrara Emilia‐Romagna Italy
Abstract
AbstractBackgroundChildren born with major congenital anomalies (CAs) have lower academic achievement compared with their peers, but the existing evidence is restricted to a number of specific CAs.ObjectivesTo investigate academic outcomes at ages 11 and 16 in children with major isolated structural CAs and children with Down or Turner syndromes.MethodsThis population‐based cohort study linked data on approximately 11,000 school‐aged children born with major CAs in 1994–2004 registered by four regional CA registries in England with education data from the National Pupil Database (NPD). The comparison group was a random sample of children without major CAs from the background population recorded in the NPD that were frequency matched (5:1) to children with CAs by birth year, sex and geographical area.ResultsOverall, 71.9%, 73.0% and 80.9% of children with isolated structural CAs achieved the expected attainment level at age 11 compared to 78.3%, 80.6% and 86.7% of the comparison group in English language, Mathematics and Science, respectively. Children with nervous system CAs as a whole had the lowest proportion who achieved the expected attainment at age 11. At age 16, 46.9% of children with CAs achieved the expected level compared to 52.5% of their peers. Major CAs were associated with being up to 9% (95% confidence interval [CI] 8%, 11%) and 12% (95% CI 9%, 14%) less likely to achieve expected levels at ages 11 and 16, respectively, after adjustment for socioeconomic deprivation.ConclusionsAlthough many children with isolated CAs achieved the expected academic level at ages 11 and 16, they were at higher risk of underachievement compared to their peers. These stark yet cautiously encouraging results are important for counselling parents of children with specific CAs and also highlight the possible need for special education support to reduce potential academic difficulties.