title: Neonatal Abstinence Syndrome and High School Performance.
abstract: OBJECTIVE
  Little is known of the long-term, including school, outcomes of children diagnosed with Neonatal abstinence syndrome (NAS) (International Statistical Classification of Disease and Related Problems [10th Edition], Australian Modification, P96.1).
  
  
  METHODS
  Linked analysis of health and curriculum-based test data for all children born in the state of New South Wales (NSW), Australia, between 2000 and 2006. Children with NAS (n = 2234) were compared with a control group matched for gestation, socioeconomic status, and gender (n = 4330, control) and with other NSW children (n = 598 265, population) for results on the National Assessment Program: Literacy and Numeracy, in grades 3, 5, and 7.
  
  
  RESULTS
  Mean test scores (range 0-1000) for children with NAS were significantly lower in grade 3 (359 vs control: 410 vs population: 421). The deficit was progressive. By grade 7, children with NAS scored lower than other children in grade 5. The risk of not meeting minimum standards was independently associated with NAS (adjusted odds ratio [aOR], 2.5; 95% confidence interval [CI], 2.2-2.7), indigenous status (aOR, 2.2; 95% CI, 2.2-2.3), male gender (aOR, 1.3; 95% CI, 1.3-1.4), and low parental education (aOR, 1.5; 95% CI, 1.1-1.6), with all Ps < .001.
  
  
  CONCLUSIONS
  A neonatal diagnostic code of NAS is strongly associated with poor and deteriorating school performance. Parental education may decrease the risk of failure. Children with NAS and their families must be identified early and provided with support to minimize the consequences of poor educational outcomes.
authors.affiliation: School of Women's and Children's Health, j.oei@unsw.edu.au.|Department of Newborn Care, Royal Hospital for Women, Randwick, New South Wales, Australia.|Ingham Research Centre, Liverpool, New South Wales, Australia.
authors.forename: Ju Lee
authors.initials: JL
authors.lastname: Oei
authors.affiliation: Early Start Research Institute and.|Department of Education, University of Oxford, Oxford, United Kingdom.|Department of Psychological Sciences, Birkbeck, University of London, London, United Kingdom.
authors.forename: Edward
authors.initials: E
authors.lastname: Melhuish
authors.affiliation: School of Women's and Children's Health.
authors.forename: Hannah
authors.initials: H
authors.lastname: Uebel
authors.affiliation: School of Women's and Children's Health.
authors.forename: Nadin
authors.initials: N
authors.lastname: Azzam
authors.affiliation: National Drug and Alcohol Research Centre, and.
authors.forename: Courtney
authors.initials: C
authors.lastname: Breen
authors.affiliation: National Drug and Alcohol Research Centre, and.
authors.forename: Lucinda
authors.initials: L
authors.lastname: Burns
authors.affiliation: National Perinatal Epidemiology and Statistics Unit, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Hilder
authors.affiliation: NSW Pregnancy and Newborn Services and.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bajuk
authors.affiliation: Department of Neonatology, The Canberra Hospital, Garran, Australian Capital Territory, Australia.|Faculty of Medicine, the Australian National University, Deakin, Australian Capital Territory, Australia.
authors.forename: Mohamed E
authors.initials: ME
authors.lastname: Abdel-Latif
authors.affiliation: School of Women's and Children's Health.|Department of Newborn Care, Royal Hospital for Women, Randwick, New South Wales, Australia.
authors.forename: Meredith
authors.initials: M
authors.lastname: Ward
authors.affiliation: School of Women's and Children's Health.|Sydney Children's Hospital, Sydney Children's Hospital Network, Randwick, New South Wales, Australia.
authors.forename: John M
authors.initials: JM
authors.lastname: Feller
authors.affiliation: The Langton Centre, Surry Hills, New South Wales, Australia.
authors.forename: Janet
authors.initials: J
authors.lastname: Falconer
authors.affiliation: The Langton Centre, Surry Hills, New South Wales, Australia.
authors.forename: Sara
authors.initials: S
authors.lastname: Clews
authors.affiliation: School of Women's and Children's Health.|Ingham Research Centre, Liverpool, New South Wales, Australia.|Community Health Services, Sydney Local Health District, Sydney, New South Wales, Australia.|School of Public Health, Menzies Centre for Health Policy, and Charles Perkins Centre, University of Sydney, Camperdown, New South Wales, Australia; and.|School of Medicine, Griffith University, Gold Coast, Queensland, Australia.
authors.forename: John
authors.initials: J
authors.lastname: Eastwood
authors.affiliation: School of Women's and Children's Health.
authors.forename: Annie
authors.initials: A
authors.lastname: Li
authors.affiliation: Early Start Research Institute and.|Illawarra Health and Medical Research Institute and School of Medicine, The University of Wollongong, Wollongong, New South Wales, Australia.|Department of Paediatrics, The Wollongong Hospital, Wollongong, New South Wales, Australia.
authors.forename: Ian M
authors.initials: IM
authors.lastname: Wright
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003479:Curriculum; D004521:Educational Measurement; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007859:Learning Disabilities / Q000175:diagnosis* / Q000453:epidemiology; D008137:Longitudinal Studies; D009357:Neonatal Abstinence Syndrome / Q000175:diagnosis* / Q000453:epidemiology; D009517:New South Wales; D011247:Pregnancy; D057216:Propensity Score