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Investigating the relationship between fetal growth and academic attainment: secondary analysis of the Born in Bradford (BiB) cohort
International Journal of Epidemiology ( IF 7.7 ) Pub Date : 2018-07-27 , DOI: 10.1093/ije/dyy157
Tom Norris 1, 2 , William Johnson 2 , Emily Petherick 2 , Noel Cameron 2 , Sam Oddie 3 , Samantha Johnson 1 , John Wright 4 , Elizabeth Draper 1 , Philip N Baker 5
Affiliation  

Background
The relationship between ultrasongraphically derived estimates of fetal growth and educational attainment in the postnatal period is unknown. Results from previous studies focusing on cognitive ability, however, suggest there may be gestation-specific associations. Our objective was to model growth in fetal weight (EFW) and head circumference (HC) and identify whether growth variation in different periods was related to academic attainment in middle childhood.
Methods
Data come from the Born in Bradford (BiB) cohort study, which has performed data linkage to both routine antenatal scans and national academic attainment tests at age 6–7 years. Multilevel linear spline models were used to model EFW and HC. Random effects from these were related to Key Stage 1 (KS1) results in reading, writing, mathematics, science and a composite of all four (age 6–7 years), using ordinal logistic and logistic regression. Associations were adjusted for potential confounders, facilitated by directed acyclic graphs. Missing covariate data were imputed using multiple imputation.
Results
In all, 6995 and 8438 children had complete KS1, and EFW and HC data, respectively. Positive associations were observed between both fetal weight in early pregnancy (14 weeks) and EFW growth in mid-pregnancy (14-26 weeks) and the individual KS1 outcomes. Furthermore, after adjustment for previous size and confounders, a 1-z score increase in growth in mid-pregnancy was associated with an 8% increased odds of achieving the expected standard for all KS1 outcomes [odds ratio (OR): 1.08, 95% confidence interval (CI): 1.02; 1.13]. Similar results were observed for HC, with generally larger effect sizes. Smaller associations were observed with growth in the early-third trimester, with no associations observed with growth in the later-third trimester.
Conclusions
We observed consistent positive associations between fetal size and growth in early and mid-gestation and academic attainment in childhood. The smaller and null associations with growth in the early-third and later-third trimester, respectively, suggests that early-mid gestation may be a sensitive period for future cognitive development.


中文翻译:

研究胎儿成长与学业成绩之间的关系:对布拉德福德出生(BiB)队列的次要分析

背景
出生后超声检查得出的胎儿生长估计值与受教育程度之间的关系是未知的。但是,先前关于认知能力的研究结果表明,可能存在特定于妊娠的关联。我们的目标是对胎儿体重(EFW)和头围(HC)的生长进行建模,并确定不同时期的生长变化是否与儿童中期的学业成就有关。
方法
数据来自布拉德福德出生(BiB)队列研究,该研究已将数据与6-7岁时的常规产前扫描和国家学历测试进行了关联。使用多级线性样条模型对EFW和HC进行建模。这些结果的随机影响与主要阶段1(KS1)在阅读,写作,数学,科学以及所有这四个阶段(6至7岁)的综合结果上的相关性(使用有序逻辑和逻辑回归)。在有向无环图的帮助下,针对潜在的混杂因素对关联进行了调整。缺失的协变量数据是使用多重插补估算的。
结果
总共有6995名儿童和8438名儿童分别具有完整的KS1,EFW和HC数据。观察到妊娠早期(14周)的胎儿体重和妊娠中期(14-26周)的EFW增长与个体KS1结局之间呈正相关。此外,在对先前的大小和混杂因素进行调整后,妊娠中期增长的1-z得分增加,与所有KS1结局达到预期标准的几率增加了8%[几率(OR):1.08,95%置信区间(CI):1.02;1.13]。对于HC观察到相似的结果,通常具有更大的效应大小。在孕晚期的早期观察到较小的相关性,在孕晚期的晚期没有观察到相关性。
结论
我们观察到胎儿大小与妊娠早期和中期的增长以及儿童学业之间的一致性呈正相关。妊娠早期和晚期分别与较小的和零相关的增长表明妊娠中期可能是未来认知发展的敏感时期。
更新日期:2018-11-02
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