Small-for-Gestational-Age and Vocabulary and Achievement Test Scores at Age 9 Among Children Born at Term in a Contemporary U.S. Sample

Nancy E. Reichman, Hope Corman, Kelly Noonan, Erini D. Papas, Kirsten B. Kuhn, Thomas Hegyi

Research output: Contribution to journalArticlepeer-review


Introduction: Children that are small-for-gestational-age (SGA) at birth are at an increased risk for cognitive impairment, even if born at term (37–41 weeks). This study examined associations between sex-specific SGA and vocabulary and achievement tests in 9 year old children born at term using a contemporary population-based US sample. Methods: A secondary data analysis was conducted on a sample of 2144 children born at term in 1998–2000 who participated in a US birth cohort study that oversampled non-marital births, which in the U.S. are associated with socioeconomic disadvantage and racial minority status. Vocabulary and achievement tests were administered to participants at age 9. Unadjusted and adjusted Ordinary Least Squares and logistic regression models of associations between SGA and test scores were estimated. Results: Sex-specific SGA was associated with 2–5 point lower test scores and 1–2 times the odds of scores less than 85 (> 1 SD below the national mean) across most outcomes. In adjusted models, measures of SGA were associated with low scores on the Woodcock–Johnson Applied Problems test (OR 2.257; 95% CI 1.434, 3.551) and the Woodcock–Johnson Passage Comprehension test (OR 1.554; 95% CI 1.132, 2.134). Conclusion: The findings validate previous studies of SGA at term and cognitive outcomes and provide further evidence using a contemporary high-risk population-based US sample. The findings suggest that SGA children born at term should be recruited for early interventions to promote improved cognitive functioning in school.

Original languageEnglish (US)
Pages (from-to)2156-2164
Number of pages9
JournalMaternal and Child Health Journal
Issue number12
StatePublished - Dec 2023

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Obstetrics and Gynecology
  • Epidemiology
  • Pediatrics, Perinatology, and Child Health


  • Achievement
  • Cognitive
  • SGA
  • Small-for-gestational-age
  • Test scores


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