Abstract
The objective of the study is to investigate the role of mental health in the relationship between moderately low birthweight MLBW (>= 1500 g & <=2500) and academic achievement in a large cross-country study. Data were drawn from the School Children Mental Health in Europe study (n = 4305). Achievement in mathematics and reading was categorized by teachers as being below average, average or above average. Parents reported birthweight, and both parents and teachers evaluated mental health status using the Strengths and difficulties Questionnaire. When controlling for child age, number of children in the household, maternal age, education, employment status and psychological distress and country of residence, MLBW was associated with lower odds of above average performance in mathematics and reading. Once mental health was added into the model, MLBW remained significant but mental health problems largely surpassed its influence: conduct disorders decreased the probability to perform above average in mathematics RRR = 0.37 and increased the risk of performing below average RRR = 4.45 as did ADHD and emotional disorders. A similar trend was found for reading achievement except for ADHD which decreased the probability of above average performance RRR = 0.13 and did not have a significant effect on below average performance. A path analysis highlights the prominent role of mental health. Among children attending regular education settings, MLBW is associated with academic performance but mental health has much stronger effects. Teachers and parents should be sensitized to child mental health problems and be informed of the special needs of MLBW children in order to help children overcome potential academic difficulties and to adapt their teaching taking into account mental health problems.
