Objective To evaluate the neurobehavioral outcomes of preterm infants with intrauterine growth restriction (IUGR), with and without prenatal advanced brainsparing. Methods

Preterm birth has an important impact on the neurodevelopmental and cognitive outcome of children at 9 years of age, being a risk factor for decreased regional cortical GM and WM even in preterm children with low risk for neurodevelopmental deficits.

Term SGA newborns with no signs of placental insufficiency had poorer neurobehavioral competencies, which suggests delayed neurologic maturation.

Objective: To explore the association between fetal cerebroplacental ratio (CPR) and frontal brain perfusion at third trimester with neonatal neurobehavioral performance in normally grown fetuses. Methods: CPR and frontal brain perfusion measured by fractional moving blood volume (FMBV) were assessed in 258 consecutive healthy fetuses at routine third trimester scan (32-35.6 weeks). Neonates were evaluated with the Neonatal Behavioral Assessment Scale. The association between Doppler parameters and neurobehavior was analyzed by MANCOVA (multiple analysis of covariance) and logistic regression, with adjustment for smoking, socioeconomic class, mode of delivery, gestational age at birth, postnatal days at examination and gender. Results: Fetuses with increased FMBV (in the upper quartile) had lower neurobehavioral scores in all areas, reaching significance in motor (5.6 vs. 5.8; p = 0.049), social (6 vs. 6.4; p = 0.006) and attention (5.3 vs. 5.9; p = 0.032). Fetuses with increased FMBV had higher risk of abnormal (<10th centile) motor (OR 3.3; 95% CI 1.36-8.1), social (OR 2.9; 95 CI% 1.33-6.5) and attention (OR 2.5; 95% CI 1.1-5.8) scores. Fetuses with lower CPR (in the lower quartile) did not differ in their neurobehavioral scores from those with normal values. Conclusions: Normally grown fetuses with increased frontal brain perfusion have poorer neurobehavioral competences, suggesting a disrupted neurological maturation. The results support the existence of forms of placental insufficiency not detected by current definitions of growth restriction.

Research on adjustment of internationally adopted children indicates that, although they have adequate development, more emotional and behavioral problems are detected compared with nonadopted children. In this research, emotional and behavioral characteristics of a sample of 52 internationally adopted minors were examined with the BASC (Parent Rating Scales and Self-Report of Personality), comparing the outcomes with 44 nonadopted minors, all of them of ages between 6 and 11 years (mean age = 8.01 years). Results indicate differences between adopted and nonadopted children related to somatization, adopted minors are those that obtain lower scores in the scale, and in the adaptability scale, where nonadopted minors obtain higher scores. Significant differences were found in the adaptive abilities scales, suggesting that nonadopted boys show better abilities than adopted ones, and no differences were found among girls. In general, boys present higher scores in externalizing symptomatology and depression than girls. Among adopted children, time spent in an institution is a variable that has negative impact on the onset of externalizing and internalizing problems. Minors coming from Eastern Europe display more attentional problems, poorer adaptive abilities and poorer interpersonal relations than the rest of the minors. According to the age at placement, attentional problems appear in minors adopted after the age of 3 years.