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Investigating the relationship between fetal growth and academic attainment: secondary analysis of the Born in Bradford (BiB) cohort

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posted on 09.07.2018 by Tom Norris, Will Johnson, Emily Petherick, Noel Cameron, Sam J. Oddie, Samantha Johnson, John Wright, Elizabeth S. Draper, P.N. Baker
Background: The relationship between ultrasongraphically derived estimates of fetal growth and educational attainment in the postnatal period is unknown. Results from previous studies focussing 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 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 was imputed using multiple imputation. Results: 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 weeks-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 (OR: 1.08, 95% CI: 1.02; 1.13). Similar results were observed for HC, with generally larger effect sizes. Smaller associations were observed with growth in early-third trimester, with no associations observed with growth in 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.


BiB receives core infrastructure funding from the Wellcome Trust (WT101597MA) and a joint grant from the UK Medical Research Council (MRC) and Economic and Social Science Research Council (ESRC) (MR/N024397/1). J Wright was supported by the NIHR Collaboration for Leadership in Applied Health Research and Care Yorkshire and Humber (NIHR CLAHRC YH) www.clahrc-yh.nihr.ac.uk. W Johnson is supported by a UK Medical Research Council (MRC) New Investigator Research Grant (MR/P023347/1), and acknowledges support from the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre.



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International Journal of Epidemiology


NORRIS, T. ...et al., 2018. Investigating the relationship between fetal growth and academic attainment: secondary analysis of the Born in Bradford (BiB) cohort. International Journal of Epidemiology, 47(5), pp. 1475–1484.


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