Silent cerebral infarction, income, and grade retention among 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
Am J Hematol. 2014 89 (10): E188-92

PMID: 25042018 · PMCID: PMC4261188 · DOI:10.1002/ajh.23805

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.

© 2014 Wiley Periodicals, Inc.

MeSH Terms (11)

Adolescent Anemia, Sickle Cell Cerebral Infarction Child Child, Preschool Cross-Sectional Studies Educational Status Humans Male Models, Biological United States

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