Neurodevelopment of small-for-gestational age infants: behavioral aspects in first year

Mello, Bernadete Balanin Almeida; Gagliardo, Heloísa Gagheggi Ravanini Gardon; Gonçalves, Vanda G.

doi:10.1590/0004-282x20140096

Cited by 7 publications

(4 citation statements)

References 22 publications

(20 reference statements)

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“…In total, 89 samples from 60 studies including 52 822 children compared preterm and term-born children who had IUGR and were SGA with children with AGA with respect to cognitive outcomes. A total of 48 studies reported results for mean cognitive scores, and 24 studies reported the percentages of group-specific children with BII …”

Section: Resultsmentioning

confidence: 99%

Association of Intrauterine Growth Restriction and Small for Gestational Age Status With Childhood Cognitive Outcomes

et al. 2020

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The magnitude of the association of intrauterine growth restriction (IUGR) and small for gestational age (SGA) status with cognitive outcomes in preterm and term-born children has not been established.OBJECTIVE To examine cognitive outcomes of preterm and term-born children who had IUGR and were SGA compared with children who were appropriate for gestational age (AGA) during the first 12 years of life.DATA SOURCES For this systematic review and meta-analysis, the Scopus, PubMed, Web of Science, Science Direct, PsycInfo, and ERIC databases were searched for English-language, peer-reviewed literature published between January 1, 2000, and February 20, 2020. The following Medical Subject Heading terms for IUGR and SGA and cognitive outcomes were used: intrauterine growth restriction, intrauterine growth retardation, small for gestational age AND neurodevelopment, neurodevelopmental outcome, developmental outcomes, and cognitive development.STUDY SELECTION Inclusion criteria were assessment of cognitive outcomes (full-scale IQ or a cognitive subscale), inclusion of an AGA group as comparison group, and inclusion of gestational age at birth and completion of cognitive assessment up to 12 years of age. DATA EXTRACTION AND SYNTHESISThe Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guidelines were followed. Data were double screened for full-text articles, and a subset were independently coded by 2 authors. Standardized mean differences (SMDs) and odd ratios from individual studies were pooled by applying random-effects models. MAIN OUTCOMES AND MEASURESCognitive outcomes, defined as mental, cognitive, or IQ scores, estimated with standardized practitioner-based cognitive tests or as borderline intellectual impairment (BII), defined as mental, cognitive, or IQ scores at least 1 SD below the mean cognitive score. RESULTSIn this study of 89 samples from 60 studies including 52 822 children, children who had IUGR and were SGA had significantly poorer cognitive outcomes (eg, cognitive scores and BII) than children with AGA in childhood. For cognitive scores, associations are consistent for preterm (SMD, −0.27; 95% CI, −0.38 to −0.17) and term-born children (SMD, −0.39; 95% CI, −0.50 to −0.28), with higher effect sizes reported for term-born IUGR and AGA group comparisons (SMD, -0.58; 95% CI, -0.82 to -0.35). Analyses on BII revealed a significantly increased risk in the preterm children who had IUGR and were SGA (odds ratio, 1.57; 95% CI, 1.40-1.77) compared with the children with AGA.CONCLUSIONS AND RELEVANCE Growth vulnerabilities assessed antenatally (IUGR) and at the time of birth (SGA) are significantly associated with lower childhood cognitive outcomes in preterm and term-born children compared with children with AGA. These findings highlight the need to develop interventions that boost cognitive functions in these high-risk groups.

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Section: Resultsmentioning

confidence: 99%

Association of Intrauterine Growth Restriction and Small for Gestational Age Status With Childhood Cognitive Outcomes

et al. 2020

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“…There are many research trials confirming the impact of SGA on neurodevelopmental delay in children born on time (23,24). In recent years, studies have concentrated on evaluating the possibility of SGA being an independent risk factor for developmental impairment in premature children.…”

Section: Discussionmentioning

confidence: 99%

Small for Gestational Age is an Independent Risk Factor for Neurodevelopmental Impairment

et al. 2020

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Background: There is a deficit of publications regarding the impact of small for gestational age (SGA) on later neurodevelopment of premature infants and existing results are conflicting. Objectives: The aim of the present study was multifaceted neurodevelopmental assessment of children born prematurely, with particular assessment of SGA as an independent risk factor for impairment in prematurely born children. Methods: Eighty-nine children born with very low birth weight were evaluated at the age of 50 months. Anthropometric measurements and several psychomotor tests (WeeFIM-Functional Independence Measure scale, Leiter Test-Non-Verbal Psychometric Evaluation, DTVP-2-Developmental test of Visual Perception, CAST-Childhood Autism Spectrum test, EAS-C-temperament questionnaire and TSD-children vocabulary test) were performed in each child. Results: SGA occurred to be the risk factor of low self-reliance (mean WeeFIM score 89 ± 20 points vs 99 ± 15; P = 0.034), decreased nonverbal intelligence (Leiter score 87 ± 18 points vs 100 ± 18 points; P = 0.022) and low visual perception (Frostig test 81 ± 17 points vs 93 ± 17 points; P = 0.035). Moreover the incidence of autism spectrum disorders was significantly higher in the SGA group (21% vs 2.8%; P = 0.029). There were no differences in frequency of cerebral palsy diagnosis, vocabulary test results and temper tests scores between SGA and AGA groups. Conclusions: Birth weight small for gestational age seems to be an additional, independent risk factor of neurodevelopmental delay in prematurely born children.

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“…Numerous epidemiologic studies have suggested broad associations between small size at term birth and risk of suboptimal or damaged neurodevelopment. [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44] Most are small or include only single outcomes, such as cognition, behavior, school performance, and general neurodevelopment at various ages. There are fewer studies of risk among term births for specific neurodevelopmental outcomes.…”

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confidence: 99%

Term Birth Weight and Neurodevelopmental Outcomes

2021

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Background: Preterm birth is an important risk factor for neurodevelopmental disabilities. The vast majority of these disabilities occur, however, among term births. The role of fetal growth restriction specifically among term babies has been incompletely described. Methods: We conducted a population-based study of term birth weight and its link to a range of neurodevelopmental outcomes using Norwegian health registries. To remove the influence of preterm birth, we restricted our analyses to 1.8 million singleton babies born during a narrow range of term gestational age (39-41 weeks). Babies with malformations were excluded. We adjusted analyses simply for year of birth, as further adjustments for sex, parity, maternal age, smoking, marital status, immigrant status, and parental education had trivial influence. An additional sibling analysis controlled for unmeasured family-based confounding. Results: The risk of neurodevelopmental disabilities at term steadily increased at birth weights lower than 3.5 kg. Using the category of 3.5-3.9 kg as the reference, the odds reached 25-fold for cerebral palsy at the smallest weights (95% confidence interval 8.0, 79), 16-fold for vision/hearing disability (4.0, 65), 11-fold for intellectual impairment (6.9, 17), 7-fold for schizophrenia (1.0, 50), 5.4-fold for epilepsy (2.6, 12), and 3.5-fold for autism spectrum (1.3, 9.4) and behavioral disorders including attention-deficit hyperactivity disorder (2.1, 5.4). Associations remained robust with sibling controls. Conclusions: Reduced fetal growth is a powerful predictor of a wide variety of neurodevelopmental disabilities independent of preterm delivery.

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Neurodevelopment of small-for-gestational age infants: behavioral aspects in first year

Cited by 7 publications

References 22 publications

Association of Intrauterine Growth Restriction and Small for Gestational Age Status With Childhood Cognitive Outcomes

Association of Intrauterine Growth Restriction and Small for Gestational Age Status With Childhood Cognitive Outcomes

Small for Gestational Age is an Independent Risk Factor for Neurodevelopmental Impairment

Term Birth Weight and Neurodevelopmental Outcomes

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