Health at birth linked to teen academic performance: Study
Kids with Apgar score below 7 were about twice as likely to go on to special schools as kids with high Apgar scores.
Babies who get low scores on a test of heart, lung and brain function given just a few minutes after birth may be more likely to need special education as teenagers, suggests a new study from Sweden.
But an outside researcher said that the chance of going to a special school was still low enough that parents shouldn't be concerned so long as their kids with a low so-called "Apgar score" do fine early in life.
Apgar scores are measured one minute after birth and again five minutes after birth. They're rated on a scale of 0 to 10, with 10 meaning a baby is very pink and breathing well, has a fast enough heart rate and has good reflexes and muscle tone.
"It's simply a measure of how well the baby has transitioned from intrauterine life," said Dr. Nigel Paneth, a pediatrician at Michigan State University in East Lansing.
While a low Apgar score might mean that something went wrong during delivery – for example, the baby was deprived of oxygen at some point – "Apgar score to some extent reflects the underlying condition of the baby and the baby's brain," added Paneth, who was not involved in the new study.
A couple of things are known for sure about babies with very low Apgar scores, he said: they have a higher risk of dying soon after birth, and they also are more likely to have cerebral palsy, a group of brain disorders that originate during development.
Other than that, Paneth added, only weak connections have been found between Apgar scores and how well a kid does later on.
In the current study, researchers led by Dr. Andrea Stuart of Central Hospital in Helsingborg used large Swedish databases to link Apgar scores with kids' grades in school and their chances of being in a special-education school.
The researchers had data on close to 900,000 babies born between 1973 and 1986.
Most of those kids had a normal Apgar score of 9 or 10 at the five-minute test. Only about 1 percent had a score below 7 and one-third of those were below 4, indicating serious immediate problems.
In total, about 23,000 of the kids were going to a special-education school at age 16.
Kids with an Apgar score below 7 were about twice as likely to go on to special schools as kids with high Apgar scores. Kids who had scores as low as 2 or 3 were about three times more likely to need special education.
Still, the authors point out in Obstetrics & Gynecology, only 1 in 44 babies with a score below 7 will go on to need special education because of whatever caused that low score at birth.
That shows that the Apgar score really doesn't help predict which kids will end up needing more help in school, Paneth said.
"The vast majority of these kids with Apgars of 7 or less are going to normal schools and they're getting good grades," he said – though on average, these kids did slightly worse in normal schools than kids who had scores of 9 or 10.
The findings also can't prove that low Apgar scores – or whatever made babies have trouble early on – caused more of them to need extra help in school as teens. But "the reasons leading to a low Apgar score ... might have an impact on future brain function," Stuart told Reuters Health in an email.
She added that kids with low scores shouldn't be singled out.
"Children born with a low Apgar score should not be seen as a separate group, but each child should be treated individually, both medically and academically, based on its medical needs and academic capacity."
But an outside researcher said that the chance of going to a special school was still low enough that parents shouldn't be concerned so long as their kids with a low so-called "Apgar score" do fine early in life.
Apgar scores are measured one minute after birth and again five minutes after birth. They're rated on a scale of 0 to 10, with 10 meaning a baby is very pink and breathing well, has a fast enough heart rate and has good reflexes and muscle tone.
"It's simply a measure of how well the baby has transitioned from intrauterine life," said Dr. Nigel Paneth, a pediatrician at Michigan State University in East Lansing.
While a low Apgar score might mean that something went wrong during delivery – for example, the baby was deprived of oxygen at some point – "Apgar score to some extent reflects the underlying condition of the baby and the baby's brain," added Paneth, who was not involved in the new study.
A couple of things are known for sure about babies with very low Apgar scores, he said: they have a higher risk of dying soon after birth, and they also are more likely to have cerebral palsy, a group of brain disorders that originate during development.
Other than that, Paneth added, only weak connections have been found between Apgar scores and how well a kid does later on.
In the current study, researchers led by Dr. Andrea Stuart of Central Hospital in Helsingborg used large Swedish databases to link Apgar scores with kids' grades in school and their chances of being in a special-education school.
The researchers had data on close to 900,000 babies born between 1973 and 1986.
Most of those kids had a normal Apgar score of 9 or 10 at the five-minute test. Only about 1 percent had a score below 7 and one-third of those were below 4, indicating serious immediate problems.
In total, about 23,000 of the kids were going to a special-education school at age 16.
Kids with an Apgar score below 7 were about twice as likely to go on to special schools as kids with high Apgar scores. Kids who had scores as low as 2 or 3 were about three times more likely to need special education.
Still, the authors point out in Obstetrics & Gynecology, only 1 in 44 babies with a score below 7 will go on to need special education because of whatever caused that low score at birth.
That shows that the Apgar score really doesn't help predict which kids will end up needing more help in school, Paneth said.
"The vast majority of these kids with Apgars of 7 or less are going to normal schools and they're getting good grades," he said – though on average, these kids did slightly worse in normal schools than kids who had scores of 9 or 10.
The findings also can't prove that low Apgar scores – or whatever made babies have trouble early on – caused more of them to need extra help in school as teens. But "the reasons leading to a low Apgar score ... might have an impact on future brain function," Stuart told Reuters Health in an email.
She added that kids with low scores shouldn't be singled out.
"Children born with a low Apgar score should not be seen as a separate group, but each child should be treated individually, both medically and academically, based on its medical needs and academic capacity."