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What did the project achieve?
“We’ve made significant strides in understanding how complex pregnancies affect lifelong health and development,” says Professor Catherine Aiken of the University of Cambridge. “In the future, this could help identify which children are most likely to benefit from early interventions to support learning and educational development – giving them the best possible opportunity to reach their full potential.”
More than 1.7 million children in England require additional support at school because of special educational needs.1 Researchers already know that a baby’s time in the womb plays a crucial influence in shaping their later health and development, including how well they do at school. Identifying children at higher risk of learning difficulties before problems emerge could help ensure they receive the right support earlier, helping to improve educational outcomes.
This research explored whether measurements collected during pregnancy could help predict a child’s future risk of developmental delay and poorer educational outcomes. The team analysed detailed information, including data from ultrasound scans, from women who took part in the Pregnancy Outcome Prediction Study, which recruited more than 4,000 pregnant mothers who attended a hospital in Cambridge between 2008 and 2012.
The researchers found that children whose growth was restricted in the womb were more likely to miss national educational targets between the ages of five and seven, compared with children whose growth was normal during pregnancy.
“Our findings provide important new evidence that problems affecting a baby’s growth in the womb – such as the placenta not working as well as it should – can have lasting consequences for educational development,” says Professor Aiken. “At the same time, we showed that children born to mothers with gestational diabetes during pregnancy are not at increased risk of poorer educational attainment, which will provide reassurance for pregnant women and clinicians.”
The team also investigated the impact of maternal anaemia – low iron levels during pregnancy – on children’s neurodevelopmental outcomes. They found that anaemia at 28 weeks of pregnancy was linked with lower educational attainment at age five, although this effect was no longer seen by six to seven years.
“Anaemia is one of the most common pregnancy complications worldwide, so understanding whether maternal blood counts affect children’s brain development is an important area of research,” says Professor Aiken. “Our findings suggest that while maternal anaemia may have some short-term effects on early educational outcomes, increasing maternal iron levels in high-resource settings is unlikely to impact educational attainment in the longer term.”
More recently, the researchers have developed new methods combining pregnancy measurements with genetic information, which could further improve risk prediction models in the future.
References
- Special educational needs in England, Academic year 2024/25: https://explore-education-statistics.service.gov.uk/find-statistics/special-educational-needs-in-england/2024-25[website accessed 11 May 2026]
This research was completed on
How are children’s lives affected now?
Research tells us that a baby’s time in the womb has a crucial influence in shaping their later health and development, including how well they do at school. For example, evidence shows that children who are born small for their gestational age are more likely to have poorer educational outcomes.
“Babies who are low birth weight are likely to do less well at school than children who were average weight,” says Dr Aiken.
Although early interventions to support a child’s learning can help give them the best possible chance of educational success, we do not currently understand enough about the impact of being born small on a child’s brain development to know exactly who may need this extra help.
“Identifying which babies are most likely to experience challenges that impact on their education would help ensure they receive the support they need both at home and at school,” says Dr Aiken.
How could this research help?
“We aim to find new ways of using measurements collected during pregnancy to help predict a child’s likelihood of developmental delay and poorer educational outcomes,” says Dr Aiken.
The team will study detailed data, such as ultrasound scans, collected from over 4,000 expectant mothers who took part in the Pregnancy Outcome Prediction Study. As their children are now at primary school, information is becoming available about their educational needs and achievements.
“By linking current educational outcomes with pregnancy data, we hope to pinpoint specific growth-related measurements taken before birth that can help predict a baby’s likelihood of future learning difficulties,” says Dr Aiken.
The researchers will focus on around 400 children in the study who were born small for their gestational age.
“If we can assess a baby’s chances of future developmental delay, this would means steps can be taken to ensure children at increased risk are given the best possible chance of success,” says Dr Aiken.
References
Department for Education, Special Education needs in England: January 2018: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/729208/SEN_2018_Text.pdf
Research table
Project details
| Project Leader | Dr Catherine Aiken, MBBChir MA PhD MRCP MRCOG |
| Location | University Department of Obstetrics and Gynaecology, University of Cambridge |
| Project Team |
Dr Hilary S Wong, MBChB PhD MRCPCH.
Professor Gordon Smith, MD PhD DSc FRCOG FMedSci. |
| Other Locations | University Department of Paediatrics, University of Cambridge |
| Grant Awarded | |
| Grant Amount | £138,073 |
| Start Date | |
| End Date | |
| Duration | 36 months |
| Grant Code (GN number) | GN2788 |
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