Silent cerebral infarction, income, and grade retention among students with sickle cell anemia.
Journal Article (Clinical Trial;Journal Article;Multicenter Study)
Children with sickle cell anemia have a higher-than-expected prevalence of poor educational attainment. We test two key hypotheses about educational attainment among students with sickle cell anemia, as measured by grade retention and use of special education services: (1) lower household per capita income is associated with lower educational attainment; (2) the presence of a silent cerebral infarct is associated with lower educational attainment. We conducted a multicenter, cross-sectional study of cases from 22 U.S. sites included in the Silent Infarct Transfusion Trial. During screening, parents completed a questionnaire that included sociodemographic information and details of their child's academic status. Of 835 students, 670 were evaluable; 536 had data on all covariates and were used for analysis. The students' mean age was 9.4 years (range: 5-15) with 52.2% male; 17.5% of students were retained one grade level and 18.3% received special education services. A multiple variable logistic regression model identified that lower household per capita income (odds ratio [OR] of quartile 1 = 6.36, OR of quartile 2 = 4.7, OR of quartile 3 = 3.87; P = 0.001 for linear trend), age (OR = 1.3; P < 0.001), and male gender (OR, 2.2; P = 0.001) were associated with grade retention; silent cerebral infarct (P = 0.31) and painful episodes (P = 0.60) were not. Among students with sickle cell anemia, household per capita income is associated with grade retention, whereas the presence of a silent cerebral infarct is not. Future educational interventions will need to address both the medical and socioeconomic issues that affect students with sickle cell anemia.
- King, AA; Rodeghier, MJ; Panepinto, JA; Strouse, JJ; Casella, JF; Quinn, CT; Dowling, MM; Sarnaik, SA; Thompson, AA; Woods, GM; Minniti, CP; Redding-Lallinger, RC; Kirby-Allen, M; Kirkham, FJ; McKinstry, R; Noetzel, MJ; White, DA; Kwiatkowski, JK; Howard, TH; Kalinyak, KA; Inusa, B; Rhodes, MM; Heiny, ME; Fuh, B; Fixler, JM; Gordon, MO; DeBaun, MR
- October 2014
Volume / Issue
- 89 / 10
Start / End Page
- E188 - E192
Pubmed Central ID
Electronic International Standard Serial Number (EISSN)
Digital Object Identifier (DOI)
- United States