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

Norris, Tom, Johnson, William, Petherick, Emily, Cameron, Noel, Oddie, Sam, Johnson, Samantha, Wright, John, Draper, Elizabeth and Baker, Philip N. (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. ISSN 0300-5771

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Abstract

Background: The relationship between ultrasongraphically derived estimates of fetal growth and educational attainment in the postnatal period is unknown. Results from previous studies focusing 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 Key Stage 1 (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 were imputed using multiple imputation.  Results: In all, 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 (14-26 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 [odds ratio (OR): 1.08, 95% confidence interval (CI): 1.02; 1.13]. Similar results were observed for HC, with generally larger effect sizes. Smaller associations were observed with growth in the early-third trimester, with no associations observed with growth in the 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.

Item Type: Article
Additional Information: The views and opinions expressed are those of the author(s), and not necessarily those of the NHS, the NIHR or the Department of Health. Born in Bradford is only possible because of the enthusiasm and commitment of the children and parents in Born in Bradford. The authors are grateful to all participants, health professionals and researchers who have made Born in Bradford happen. We are particularly grateful to all the school nurse teams in Bradford for their support and enthusiasm for this study.
Uncontrolled Keywords: attainment,born in bradford,education,fetal growth,longitudinal,spline,epidemiology ,/dk/atira/pure/subjectarea/asjc/2700/2713
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Depositing User: LivePure Connector
Date Deposited: 27 Jan 2026 12:30
Last Modified: 30 Jan 2026 12:30
URI: https://ueaeprints.uea.ac.uk/id/eprint/101743
DOI: 10.1093/ije/dyy157

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