Educational Outcomes at 7, 11 and 16 Years of Age for Children Born Small for Gestational Age: Results From the Auckland Birthweight Collaborative Study

ABSTRACT Aim Small for gestational age (SGA) has been linked to lower school achievement in childhood. However, this association has only been shown consistently in preterm‐SGA cohorts. This paper aims to determine whether being born SGA at term is associated with school performance at 7, 11 and 16 years of age. Methods n = 871 children born at term ( n = 433 small‐for‐gestational‐age [SGA] and n = 438 appropriate for gestational age [AGA]) had education outcomes analysed at age 7 ( n = 265 SGA, n = 304 AGA), 11 ( n = 200 SGA, n = 218 AGA) and 16 ( n = 152 SGA, n = 185 AGA). The outcomes studied were the risk of below‐average achievement in oral comprehension, written comprehension and mathematics at 7 and 11 years of age, and the risk of not achieving final secondary school qualifications at 16. Binary and multinomial logistic regression were performed. Results SGA children score below‐average in written comprehension at 7 (OR 1.71, CI 1.04–2.80) and oral comprehension at 11 (OR 2.10, CI 1.22–3.62). These associations were not statistically significant once adjusted for confounders (written comprehension at 7 aOR 1.54, CI 0.89–2.69; oral comprehension at 11 aOR 1.79, CI 0.99–3.25). There was no statistically significant difference in secondary school achievement (OR 0.80, 95% CI 0.45–1.42) between SGA and AGA children. Conclusions Our results show that being born SGA at term does not independently increase the risk of below‐average performance at ages 7, 11 or 16 after adjusting for known social and environmental confounders. However, clinicians should maintain active surveillance for term SGA infants, particularly when co‐occurring environmental or maternal risk factors are present.