School attainment of children who had a single umbilical artery at birth


Monica Lilja, MD, PhD, Department of Obstetrics and Gynecology, University Hospital, SE-221 85 Lund, Sweden.


Lilja M. School attainment of children who had a single umbilical artery at birth. Paediatric and Perinatal Epidemiology 2010; 24: 166–170.

To the best of our knowledge, this is the first registry study of school achievements among children born with a single umbilical artery (SUA). A total of 1600 infants born with SUA during 1983–86 were studied. We linked the Swedish Medical Birth Registry with the Swedish School Registry, which contains the school grades of all children in Sweden when leaving compulsory school. Risks were estimated as odds ratios (OR) using the Mantel-Haenzel procedure, after adjustment for four potential confounders: year of birth, maternal age, parity and maternal education.

There was a 60% excess of children born with SUA who did not complete compulsory school after removal of infants born preterm, small-for-gestational age and low Apgar score (OR = 1.60 [95% confidence interval 1.28, 2.00]). When sports and the three core school subjects (mathematics, English and Swedish) were studied, there was an increased risk for ‘not passed’ in all subjects except sport and a slight decrease in the probability of achieving ‘passed with distinction or excellence’. In the three core subjects there was an association with gender, boys with SUA being more likely to have ‘not passed’ than girls. In conclusion the children born with SUA are more likely than children born with three vessels to show impaired school achievements.