Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom.
Center for Clinical and Epidemiological Research, University of Ferrara, Ferrara, Emilia-Romagna, Italy.
Birth Defects Res. 2021 Dec 1;113(20):1431-1462. doi: 10.1002/bdr2.1961. Epub 2021 Oct 21.
Children with congenital anomalies have poorer intellectual and cognitive development compared to their peers, but evidence for academic achievement using objective measures is lacking. We aimed to summarize and synthesize evidence on academic outcomes and special education needs (SEN) of school-aged children born with selected major structural congenital anomalies. Electronic databases (MEDLINE, EMBASE, Scopus, PsycINFO, CINAHL, ProQuest Natural Science and Education Collections), reference lists and citations for 1990-2020 were systematically searched. We included original-research articles on academic achievement in children with non-syndromic congenital anomalies that involved school test results, standardized tests and/or SEN data. Random-effects meta-analyses were performed to estimate pooled mean test scores in mathematics and/or reading where possible and pooled odds ratios (ORs) for SEN in children with severe congenital heart defects (CHDs) and children with orofacial clefts (OFCs). Thirty-nine eligible studies (n = 21,066 children) were synthesized narratively. Sixteen studies were included in meta-analyses. Children with non-syndromic congenital anomalies were at a higher risk of academic underachievement than controls across school levels. Children with severe CHD (pooled OR = 2.32, 95% CI: 1.90, 2.82), and children with OFC (OR = 1.38 (95% CI: 1.20, 1.57), OR = 3.07 (95% CI: 2.65, 3.56), and OR = 3.96 (95% CI: 3.31, 4.72) for children with cleft lip, cleft palate and cleft lip/palate, respectively) had significantly higher ORs for SEN than controls. Children with non-syndromic congenital anomalies underperform academically and have higher SEN rates compared to their peers. Early monitoring and development of differential SEN are important to promote academic progress in these children.
与同龄人相比，患有先天性畸形的儿童在智力和认知发展方面较差，但缺乏使用客观测量方法评估学业成绩的证据。我们旨在总结和综合有关患有选定主要结构性先天性畸形的学龄儿童学业成绩和特殊教育需求（SEN）的证据。系统地检索了 1990 年至 2020 年的电子数据库（MEDLINE、EMBASE、Scopus、PsycINFO、CINAHL、ProQuest 自然科学和教育收藏）、参考文献列表和引文。我们纳入了关于非综合征性先天性畸形儿童学业成绩的原始研究文章，这些文章涉及学校考试成绩、标准化考试和/或 SEN 数据。在可能的情况下，我们进行了随机效应荟萃分析，以估计数学和/或阅读的汇总平均测试分数，并对患有严重先天性心脏病（CHD）的儿童和患有口面裂（OFC）的儿童的 SEN 汇总比值比（OR）进行估计。综合了 39 项合格研究（n=21,066 名儿童）的结果。有 16 项研究被纳入荟萃分析。与对照组相比，患有非综合征性先天性畸形的儿童在各个学校水平的学业成绩都较差。患有严重 CHD（汇总 OR=2.32，95%CI：1.90，2.82）和患有 OFC（OR=1.38（95%CI：1.20，1.57），OR=3.07（95%CI：2.65，3.56）和 OR=3.96（95%CI：3.31，4.72），分别为唇裂、腭裂和唇裂/腭裂的儿童）的儿童 SEN 发生率明显高于对照组。与同龄人相比，患有非综合征性先天性畸形的儿童学业表现较差，SEN 发生率较高。早期监测和制定不同的 SEN 方案对于促进这些儿童的学业进步很重要。
