Ju Lee Oei1,2,3, Edward Melhuish4,5,6, Hannah Uebel7, Nadin Azzam7, Courtney Breen8, Lucinda Burns8, Lisa Hilder9, Barbara Bajuk10, Mohamed E Abdel-Latif11,12, Meredith Ward7,2, John M Feller7,13, Janet Falconer14, Sara Clews14, John Eastwood7,3,15,16,17, Annie Li7, Ian M Wright4,18,19. 1. School of Women's and Children's Health, j.oei@unsw.edu.au. 2. Department of Newborn Care, Royal Hospital for Women, Randwick, New South Wales, Australia. 3. Ingham Research Centre, Liverpool, New South Wales, Australia. 4. Early Start Research Institute and. 5. Department of Education, University of Oxford, Oxford, United Kingdom. 6. Department of Psychological Sciences, Birkbeck, University of London, London, United Kingdom. 7. School of Women's and Children's Health. 8. National Drug and Alcohol Research Centre, and. 9. National Perinatal Epidemiology and Statistics Unit, University of New South Wales, Sydney, New South Wales, Australia. 10. NSW Pregnancy and Newborn Services and. 11. Department of Neonatology, The Canberra Hospital, Garran, Australian Capital Territory, Australia. 12. Faculty of Medicine, the Australian National University, Deakin, Australian Capital Territory, Australia. 13. Sydney Children's Hospital, Sydney Children's Hospital Network, Randwick, New South Wales, Australia. 14. The Langton Centre, Surry Hills, New South Wales, Australia. 15. Community Health Services, Sydney Local Health District, Sydney, New South Wales, Australia. 16. School of Public Health, Menzies Centre for Health Policy, and Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia; and. 17. School of Medicine, Griffith University, Gold Coast, Queensland, Australia. 18. Illawarra Health and Medical Research Institute and School of Medicine, The University of Wollongong, Wollongong, New South Wales, Australia. 19. Department of Paediatrics, The Wollongong Hospital, Wollongong, New South Wales, Australia.
Abstract
BACKGROUND AND OBJECTIVES: Little is known of the long-term, including school, outcomes of children diagnosed with Neonatal abstinence syndrome (NAS) (International Statistical Classification of Disease and Related Problems [10th Edition], Australian Modification, P96.1). METHODS: Linked analysis of health and curriculum-based test data for all children born in the state of New South Wales (NSW), Australia, between 2000 and 2006. Children with NAS (n = 2234) were compared with a control group matched for gestation, socioeconomic status, and gender (n = 4330, control) and with other NSW children (n = 598 265, population) for results on the National Assessment Program: Literacy and Numeracy, in grades 3, 5, and 7. RESULTS: Mean test scores (range 0-1000) for children with NAS were significantly lower in grade 3 (359 vs control: 410 vs population: 421). The deficit was progressive. By grade 7, children with NAS scored lower than other children in grade 5. The risk of not meeting minimum standards was independently associated with NAS (adjusted odds ratio [aOR], 2.5; 95% confidence interval [CI], 2.2-2.7), indigenous status (aOR, 2.2; 95% CI, 2.2-2.3), male gender (aOR, 1.3; 95% CI, 1.3-1.4), and low parental education (aOR, 1.5; 95% CI, 1.1-1.6), with all Ps < .001. CONCLUSIONS: A neonatal diagnostic code of NAS is strongly associated with poor and deteriorating school performance. Parental education may decrease the risk of failure. Children with NAS and their families must be identified early and provided with support to minimize the consequences of poor educational outcomes.
BACKGROUND AND OBJECTIVES: Little is known of the long-term, including school, outcomes of children diagnosed with Neonatal abstinence syndrome (NAS) (International Statistical Classification of Disease and Related Problems [10th Edition], Australian Modification, P96.1). METHODS: Linked analysis of health and curriculum-based test data for all children born in the state of New South Wales (NSW), Australia, between 2000 and 2006. Children with NAS (n = 2234) were compared with a control group matched for gestation, socioeconomic status, and gender (n = 4330, control) and with other NSW children (n = 598 265, population) for results on the National Assessment Program: Literacy and Numeracy, in grades 3, 5, and 7. RESULTS: Mean test scores (range 0-1000) for children with NAS were significantly lower in grade 3 (359 vs control: 410 vs population: 421). The deficit was progressive. By grade 7, children with NAS scored lower than other children in grade 5. The risk of not meeting minimum standards was independently associated with NAS (adjusted odds ratio [aOR], 2.5; 95% confidence interval [CI], 2.2-2.7), indigenous status (aOR, 2.2; 95% CI, 2.2-2.3), male gender (aOR, 1.3; 95% CI, 1.3-1.4), and low parental education (aOR, 1.5; 95% CI, 1.1-1.6), with all Ps < .001. CONCLUSIONS: A neonatal diagnostic code of NAS is strongly associated with poor and deteriorating school performance. Parental education may decrease the risk of failure. Children with NAS and their families must be identified early and provided with support to minimize the consequences of poor educational outcomes.
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