Background: Preterm infants are at higher risk for developmental problems. The aim of this study is to quantify the relation between birth weight and special educational needs.
Methods: We analyzed data from the pre-school examinations of 134 313 children in Berlin aged 5 to 6 who were examined between 2007 and 2011.
Results: Special educational needs were diagnosed in 8058 children (6.0%), 4943 (61%) of whom had weighed 3000 g or more at birth. The percentage of children with special educational needs rose steadily with decreasing birth weight (2250-2499 g, 9.2%; 1250-1499 g, 21.1%; less than 750 g, 35.6%). Logistic regression analysis yielded odds ratios and 99% confidence intervals for special educational needs that ranged from 1.32 [1.17-1.47] for birth weight 2750-2999 g to 12.83 [7.48-22.03] for birth weight less than 750 g. Further risk factors were male sex (1.88 [1.75-2.03]), low social status (5.96 [5.21-6.82]), an immigrant background associated with poor German language skills in the family (1.63 [1.43-1.86]), and being raised by a single parent (1.21 [1.12-1.31]). On the other hand, nursery school and/or kindergarten enrollment for at least two years before entering school (0.82 [0.73-0.91]) and an immigrant background with good German skills in the family (0.39 [0.34-0.45]) were associated with lower rates of special educational needs.
Conclusion: The risk of special educational needs increases already with moderately decreased birth weight. The most important factor other than birth weight is the family's social status. Although children of very low birth weight have a much higher rate of special educational needs than other children, they still make up only a small percentage of all children with special educational needs.