The Relative Risk of Educational Handicaps in Two Birth Cohorts of Normal and Low Birthweight Disadvantaged Children

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Abstract
An historical prospective study was conducted on 2 birth cohorts of children. Subjects born between 1974 and 1976 (Cohort I, n = 239) and 1978 and 1979 (Cohort II, n = 328) were identified through the medical records of one inner city teaching hospital and stratified by birthweight. The birthweight groups were very low birthweight (VLBW, < 1,500 grams), low birthweight (LBW, 1,501 to 2,500 grams), and normal birthweight (NBW, > 2,500 grams). Pertinent perinatal, neonatal, and maternal obstetric information was recorded for each subject. Children were then tracked into the county public school system to determine present educational achievement as an outcome measure. There were no significant differences between cohorts for medical variables. Results indicated an elevated risk for, and higher prevalence of students with, mild educational handicaps (learning disabled, emotionally handicapped, and educable mentally handicapped) in the LBW group of Cohort I. This was not found in Cohort II, which had a nearly equal distribution of mildly handicapped subjects for the 3 birthweight groups and a greater proportion of severely handicapped subjects than Cohort I. The cumulative incidence rate of milder handicaps is predicted to increase in Cohort II as these children age. The distribution of handicaps is analyzed, and estimated relative risk ratios are presented.

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