A Population-Based Study of Grade 12 Academic Performance in Adolescents with Childhood-onset Chronic Rheumatic Diseases

OBJECTIVE 1) To compare grade 12 standards tests results of patients diagnosed with childhoodonset chronic rheumatic diseases (ChildCRD) and unaffected peers. 2) To identify factors associated with test results of ChildCRD patients and unaffected peers. METHODS This was a population-based retrospective cohort study. All ChildCRD patients (juvenile arthritis and systemic autoimmune rheumatic diseases) from the only pediatric rheumatology centre in Manitoba for birth cohorts January 1979 to December 1998 were linked to the provincial administrative databases containing records of healthcare use and education outcomes Patients were matched by age, sex and postal codes to their peers who did not have ChildCRD. The primary outcomes were the grade 12 language arts achievement index (LAI) and the math achievement index (MAI) scores. ChildCRD, sociodemographic and mental health factors were tested for their associations with LAI and MAI scores using multivariable linear regression. RESULTS 541 ChildCRD patients were matched to 2713 unaffected peers. ChildCRD patients had lower LAI and MAI scores compared to their peers. More ChildCRD patients failed or did not take the language arts (51% vs 41%, p<0.001) and maths (61% vs 55%, p=0.017) tests. On multivariable analysis, ChildCRD, lower socioeconomic status, younger maternal age at first childbirth, family income assistance, involvement with child welfare services, and mental health morbidities (between ChildCRD diagnosis and standards testing), were associated with worse LAI and MAI results. CONCLUSION This population-based study showed that ChildCRD patients performed less well than their peers on grade 12 standards tests results, independent of sociodemographic and mental health comorbidities.