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Original article
Effect of childhood coeliac disease on ninth grade school performance: evidence from a population-based study
  1. Fredinah Namatovu1,
  2. Mattias Strandh2,
  3. Anneli Ivarsson1,
  4. Karina Nilsson3
  1. 1 Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
  2. 2 Department of Social Sciences, Umeå University, Umeå, Sweden
  3. 3 Department of Sociology, Umeå University, Umeå, Sweden
  1. Correspondence to Dr Fredinah Namatovu, Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, SE-90187 Umeå, Sweden; fredinah.namatovu{at}umu.se

Abstract

Background Coeliac disease might affect school performance due to its effect on cognitive performance and related health consequences that might increase school absenteeism. The aim of this study was to investigate whether children with coeliac disease performed differently on completion of ninth grade in school compared with children without coeliac disease.

Methods Analysis was performed on a population of 445 669 children born in Sweden between 1991 and 1994 of whom 1767 were diagnosed with coeliac disease. School performance at ninth grade was the outcome and coeliac disease was the exposure. Other covariates included sex, Apgar score at 5 min, small for gestational age, year of birth, family type, parental education and income.

Results There was no association between coeliac disease and school performance at ninth grade (adjusted coefficient −2.4, 95% CI 5.1 to 0.4). A weak association was established between late coeliac diagnosis and higher grades, but this disappeared after adjusting for parent socioeconomic conditions. Being small for gestational age affected performance negatively (adjusted coefficient −6.9, 95% CI 8.0 to 5.7). Grade scores were significantly lower in children living with a single parent (adjusted coefficient −20.6, 95% CI 20.9 to 20.2), compared with those with married/cohabiting parents. A positive association was found between scores at ninth grade and parental education and income.

Conclusion Coeliac disease diagnosis during childhood is not associated with poor school performance at ninth grade.

  • achievement
  • celiac
  • disease
  • education
  • grades
  • income
  • performance and school

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/archdischild-2017-312830

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    Footnotes

    • Contributors MS and KN were responsible for the conceptualisation of the study, supervised the analysis process and offered quality control of both data and the final study results. AI provided clinical insights and interpretation of the study variables and the research findings. FN performed the statistical analyses and wrote the manuscript. All authors contributed to the selection of the studied variables, choice of study design, interpretation of study findings, and revision of the manuscript, and have approved the submitted version of the manuscript.

    • Funding The research has been supported by grants from the Swedish Science Council (Dnr: 2014-1992) and Markus and Marianne Wallenbergs fund (Dnr: 2014.0154).

    • Competing interests None declared.

    • Ethics approval Swedish Ethical Review Board.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement All data for this study are available through the Umeå SIMSAM Lab. More data similar to the one used in this study can be obtained from Statistics Sweden and the Swedish National Board of Health and Welfare upon request and ethical clearance.