Dataset Information

Educational achievement of children with selected major congenital anomalies and associated factors: a Finnish registry-based study.

ABSTRACT:

Background

Children with major congenital anomalies may be at risk of poor educational outcomes. We aimed to evaluate the educational achievement of children born with major congenital anomalies compared with children without major congenital anomalies in relation to sociodemographic factors.

Methods

We performed a registry-based study including 401 544 children in Finland, graduates of the compulsory school who applied to secondary education. We used health data from the Finnish Register of Congenital Malformations for children born from 1995 to 2002 linked with education data from the Finnish Ministry of Education and Culture. We used generalized linear regression to compare the mean grade differences of children with specific major congenital anomalies and 'All anomalies' subgroup (major congenital anomalies, chromosomal syndromes, and multiple anomalies) with reference children.

Results

Children with major congenital anomalies were less likely to apply for further education than reference children (88.0% vs. 96.8%; odds ratio = 4.13; 95% confidence interval, 3.92-4.36). For most non-chromosomal congenital anomalies, children born with congenital anomalies had similar educational achievement to the reference children. For the 'All anomalies' subgroup, children with congenital anomalies had lower educational achievement than reference children. Among children with congenital anomalies, male sex, lower maternal educational levels and younger maternal age were associated with lower educational achievement.

Conclusions

For children applying to further education, most non-chromosomal congenital anomalies were not associated with lower educational achievement. Nevertheless, efforts are needed to improve educational achievement in children with major congenital anomalies associated with maternal sociodemographic background.

SUBMITTER: Roustaei Z

PROVIDER: S-EPMC10710322 | biostudies-literature | 2023 Aug

REPOSITORIES: biostudies-literature

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Publications

Educational achievement of children with selected major congenital anomalies and associated factors: a Finnish registry-based study.

Roustaei Zahra Z Heino Anna A Kiuru-Kuhlefelt Sonja S Morris Joan K JK Glinianaia Svetlana V SV Garne Ester E Loane Maria M Rankin Judith J Gissler Mika M

European journal of public health 20231201 6

<h4>Background</h4>Children with major congenital anomalies may be at risk of poor educational outcomes. We aimed to evaluate the educational achievement of children born with major congenital anomalies compared with children without major congenital anomalies in relation to sociodemographic factors.<h4>Methods</h4>We performed a registry-based study including 401 544 children in Finland, graduates of the compulsory school who applied to secondary education. We used health data from the Finnish ...[more]

PMID: 37594898

Similar Datasets

Project description:BackgroundChildren with major congenital anomalies (MCAs) disproportionately experience complex health problems requiring additional health and educational support.ObjectivesTo describe survival to the start of school and recorded special educational needs (SEN) provision among children with and without administrative record-identified MCAs in England. We present results for 12 system-specific MCA subgroups and 25 conditions. We also describe the change of prevalence in recorded SEN provision before and after SEN reforms in 2014, which were implemented to improve and streamline SEN provision.MethodsWe created a birth cohort of 6,180,400 singleton children born in England between 1 September 2003 and 31 August 2013 using linked administrative records from the ECHILD database. MCAs were identified using hospital admission and mortality records during infancy. SEN provision in primary school was defined by one or more recording of SEN provision in state-school records during years 1 to 6 (ages 5/6 years to 10/11 years).ResultsChildren with any MCA had a 5-year survival rate of 95.1% (95% confidence interval (CI) 95.0, 95.2) compared with 99.7% (95% CI 99.7, 99.7) among children without an MCA. 41.6% (75,381/181,324) of children with an MCA had any recorded SEN provision in primary school compared with 25.7% (1,285,572/5,008,598) of unaffected children. Of the 12 system-specific MCA subgroups, children with chromosomal, nervous system and eye anomalies had the highest prevalence of recorded SEN provision. The prevalence of recorded SEN provision decreased by 4.8% (99% CI -5.4, -4.3) for children with any MCA compared with a reduction of 4.2% (99% CI -4.3, -4.2) for unaffected children, when comparing pupils in year 1 before and after 2014.ConclusionWe observed that approximately two fifths of children with MCAs have some type of SEN provision recorded during primary school, but this proportion varied according to condition and declined following the 2014 SEN reforms, similar to children unaffected by MCAs.

Project description:ImportanceThe burden of caring for children with complex medical problems such as major congenital anomalies falls principally on mothers, who in turn suffer a variety of potentially severe economic consequences. As well, health consequences of caregiving often further impact the social and economic prospects of mothers of children with major congenital anomalies (MCMCAs). Evaluating the long-term economic consequences of extensive in-home caregiving among MCMCAs can inform strategies to mitigate these effects.ObjectiveTo assess whether MCMCAs face reduced employment and increased need for disability benefits over a 20-year period.DesignA population-based matched cohort study.SettingDenmark.ParticipantsAll women who gave birth to a singleton child with a major congenital anomaly in Denmark between January 1, 1997 and December 31, 2017 (n = 23,637) and a comparison cohort of mothers matched by maternal age, parity, and infant's year of birth (n = 234,586).ExposuresLiveborn infant with a major congenital anomaly.Main outcomes and measuresThe primary outcome was mothers' employment status, stratified by their child's age. Employment status was categorized as employed, outside the workforce (on temporary leave, holding a flexible job, or pursuing education), or unemployed; the number of weeks in each category was measured over time. The secondary outcome was time to receipt of a disability pension, which in Denmark implies permanent exit from the labor market. We used a negative binomial regression model to estimate the number of weeks in each employment category, stratified by the child's age (i.e., 0-1 year, > 1-6 years, 7-13 years, 14-18 years). A Cox proportional hazards regression model was used to compute hazard ratios as a measure of the relative risk of receiving a disability pension. Rate ratios and hazard ratios were adjusted for maternal demographics, pregnancy history, health, and infant's year of birth.ResultsDuring 1-6 years after delivery, MCMCAs were outside the workforce for a median of 50 weeks (IQR, 6-107 weeks), while members of the comparison cohort were outside the workforce for a median of 48 weeks (IQR, 4-98 weeks), corresponding to an adjusted rate ratio [ARR] of 1.05 (95% confidence interval [CI], 1.04-1.07). During the first year after delivery, MCMCAs were more likely to be employed than mothers in the comparison cohort (ARR, 1.08; 95% CI, 1.06-1.10). At all timepoints thereafter, MCMCAs had a lower rate of workforce participation. The rate of being outside the workforce was 5% higher than mothers in the comparison cohort during 1-6 years after delivery (ARR, 1.05; 95% CI, 1.04-1.07), 9% higher during 7-13 years after delivery (ARR, 1.09; 95% CI, 1.06-1.12), and 12% higher during 14-18 years after delivery (ARR, 1.12; 95% CI, 1.07-1.18). Overall, MCMCAs had a 20% increased risk of receiving a disability pension during follow-up than mothers in the matched comparison cohort [incidence rates 3.10 per 1000 person-years (95% CI, 2.89-3.32) vs. 2.34 per 1000 person-years (95% CI, 2.29-2.40), adjusted hazard ratio, 1.20; 95% CI, 1.11-1.29].Conclusion and relevanceMCMCAs were less likely to participate in the Danish workforce, less likely to be employed, and more likely to receive disability pensions than mothers of unaffected children. The rate of leaving the workforce intensified as their affected children grew older. The high demands of caregiving among MCMCAs may have long-term employment consequences even in nations with comprehensive and heavily tax-supported childcare systems, such as Denmark.

Project description:ObjectiveThis population-based, matched cohort study aimed to evaluate utilization of health care services by mothers of children with major congenital anomalies (MCAs), compared to mothers of children without MCAs over a 20-year post-birth time horizon in Denmark.MethodsOur analytic sample included mothers who gave birth to an infant with a MCA (n = 23,927) and a cohort of mothers matched to them by maternal age, parity and infant's year of birth (n = 239,076). Primary outcomes were period prevalence and mothers' quantity of health care utilization (primary, inpatient, outpatient, surgical, and psychiatric services) stratified by their child's age (i.e., ages 0-6 = before school, ages 7-13 = pre-school + primary education, and ages 14-18 = secondary education or higher). The secondary outcome measure was length of hospital stays. Outcome measures were adjusted for maternal age at delivery, parity, marital status, income quartile, level of education in the year prior to the index birth, previous spontaneous abortions, maternal pregnancy complications, maternal diabetes, hypertension, alcohol-related diseases, and maternal smoking.ResultsIn both cohorts the majority of mothers were between 26 and 35 years of age, married, and employed, and 47% were primiparous. Mothers of infants with anomalies had greater utilization of outpatient, inpatient, surgical, and psychiatric services, compared with mothers in the matched cohort. Inpatient service utilization was greater in the exposed cohort up to 13 years after a child's birth, with the highest risk in the first six years after birth [adjusted risk ratio, 1.13; 95% confidence interval (CI), 1.12-1.14], with a decrease over time. Regarding the quantity of health care utilization, the greatest difference between the two groups was in inpatient service utilization, with a 39% increased rate in the exposed cohort during the first six years after birth (adjusted rate ratio, 1.39; 95% CI, 1.37-1.42). During the first 6 years after birth, mothers of children with anomalies stayed a median of 6 days (interquartile range [IQR], 3-13) in hospital overall, while the comparison cohort stayed a median of 4 days (IQR, 2-7) in hospital overall. Rates of utilization of outpatient clinics (adjusted rate ratio, 1.36; 95% CI, 1.29-1.42), as well as inpatient (adjusted rate ratio, 1.77; 95% CI, 1.68-1.87), and surgical services (adjusted rate ratio, 1.33; 95% CI, 1.26-1.41) was higher in mothers of children with multiple-organ MCAs during 0 to 6 years after birth. Among mothers at the lowest income levels, utilization of psychiatric clinic services increased to 59% and when their child was 7 to 13 years of age (adjusted rate ratio, 1.59; 95% CI, 1.24-2.03).ConclusionMothers of infants with a major congenital anomaly had greater health care utilization across services. Health care utilization decreased over time or remained stable for outpatient, inpatient, and surgical care services, whereas psychiatric utilization increased for up to 13 years after an affected child's birth. Healthcare utilization was significantly elevated among mothers of children with multiple MCAs and among those at the lowest income levels.

Dataset Information

Educational achievement of children with selected major congenital anomalies and associated factors: a Finnish registry-based study.

Background

Methods

Results

Conclusions

Publications

Educational achievement of children with selected major congenital anomalies and associated factors: a Finnish registry-based study.

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