Fetal Growth Restriction with Brain Sparing: Neurocognitive and Behavioral Outcomes at 12 Years of Age

Beukers, Fenny; Aarnoudse-Moens, Cornelieke S.H.; Weissenbruch, Mirjam M. van; Ganzevoort, Wessel; Goudoever, Johannes B. van; Wassenaer-Leemhuis, Aleid G. van

doi:10.1016/j.jpeds.2017.06.003

Cited by 29 publications

(51 citation statements)

References 45 publications

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“…Taken together, the most common finding is that being born SGA at term does not impact significantly negatively on general intellectual functioning. The majority of studies that specifically examine FGR term children report similar performance on IQ-type measures as those found in controls (29, 39, 44, 46). Two studies reported that FGR term children have lower general intellectual functioning than controls (39, 40), but one of these studies also included a minority of preterm children, whose presence could account for these results (40).…”

Section: School Age Outcomes Of Sga And/or Fgr In Children Born At Termmentioning

confidence: 88%

“…IQ scores acquired from the Wechsler tests were the most commonly reported general cognitive outcome measures (29, 31, 32, 34, 36, 40, 42, 44, 46). There was some cross-study consensus about the effect of fetal growth restriction at term on Wechsler derived IQ scores, with three studies reporting that term FGR children's IQ scores were no different from those of control children (29, 42, 44, 46). In contrast, one study reported that FGR children's IQ scores were significantly lower than controls (40), but it should be noted that this study included both term and preterm children and thus this finding may not be isolated to term FGR children.…”

Section: School Age Outcomes Of Sga And/or Fgr In Children Born At Termmentioning

confidence: 99%

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School Age Neurological and Cognitive Outcomes of Fetal Growth Retardation or Small for Gestational Age Birth Weight

Vollmer

Edmonds

2019

Front. Endocrinol.

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Children who were growth restricted in utero (FGR) and are born small for gestational age (SGA) may experience poorer long term neurological and cognitive outcomes. Those also born preterm may have particular difficulties. The objective of this paper was to review the literature on school age neurocognitive outcome for term and preterm children that was published in the last 15 years. Considering term born children first, there is evidence that these children are at higher risk for Cerebral Palsy (CP) than those born appropriate for gestational age (AGA); information on neuromotor function in the absence of CP is somewhat contradictory. With regards to cognitive outcome, the most common finding was that being born SGA and/or FGR at term does not impact negatively on general intellectual functioning, commonly assessed by IQ scores. There was some indication that they may experience particular problems with attention. With regards to children born preterm, the risk of CP appears not to be increased compared to those preterms born AGA. For preterm children who do not develop CP, motor outcome is more affected by post-natal and post-neonatal brain growth than intrauterine growth. In contrast to term born children, preterm SGA and/or FGR children are at increased risk of cognitive and behavioral difficulties, and in common with term born children, are at higher risk than their AGA counterparts of difficulties with attentional control. In conclusion, preterm born SGA and/or FGR children are at higher risk of neurodevelopmental problems in the school years. It is important to continue to follow up children into the school age years because these difficulties may take time to emerge, and may be more visible in the more demanding school environment.

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Section: School Age Outcomes Of Sga And/or Fgr In Children Born At Termmentioning

confidence: 88%

Section: School Age Outcomes Of Sga And/or Fgr In Children Born At Termmentioning

confidence: 99%

School Age Neurological and Cognitive Outcomes of Fetal Growth Retardation or Small for Gestational Age Birth Weight

Vollmer

Edmonds

2019

Front. Endocrinol.

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“…However, the German version of the third edition was not available at the time of this study, nor is a behavioral scale, as provided by the original versions of BSID-II and BSID-III, available in the German language to date. Results of studies investigating behavioral changes in former IUGR children indicate that attention, social-interactive skills or mood might also be affected ( Roza et al, 2008 ; Beukers et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Impact of Intrauterine Growth Restriction on Cognitive and Motor Development at 2 Years of Age

et al. 2018

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Intrauterine growth restriction (IUGR), which is already known to be a risk factor for pathological intrauterine development, perinatal mortality, and morbidity, is now also assumed to cause both physical and cognitive alterations in later child development. In the current study, effects of IUGR on infantile brain function were investigated during the fetal period and in a follow-up developmental assessment during early childhood. During the fetal period, visual and auditory event-related responses (VER and AER) were recorded using fetal magnetoencephalography (fMEG). VER latencies were analyzed in 73 fetuses (14 IUGR fetuses) while AER latencies were analyzed in 66 fetuses (11 IUGR fetuses). Bayley Scales of Infant Development, Second Edition (BSID-II) were used to assess the developmental status of the infants at the age of 24 months. The Mental Development Index (MDI) was available from 66 children (8 IUGR fetuses) and the Psychomotor Development Index (PDI) from 63 children (7 IUGR fetuses). Latencies to visual stimulation were more delayed in IUGR than in small for gestational age (SGA) or appropriate for gestational age (AGA) fetuses, albeit not to any significant extent (p = 0.282). The MDI in former IUGR infants was significantly lower (p = 0.044) than in former SGA and AGA infants. However, IUGR had no impact on PDI (p = 0.213). These findings support the hypothesis that IUGR may constitute a risk factor for neurodevelopmental delay. Further investigation of the possible underlying mechanisms, as well as continued long-term developmental research, is therefore necessary.

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“…The checklist includes 99 questions about child behaviour that have to be rated as zero (never), one (a little or sometimes) or two (obviously or often) by their parents. The dependent variables that were used were the T‐score of the social and attention problem scales, since the scores on these subscales were found to be elevated in our previous study . A higher T‐score indicated more behavioural problems.…”

Section: Methodsmentioning

confidence: 99%

“…The mothers completed questionnaires on psychological distress when their child reached term age and at three months post‐term. When the children reached 12 years of age, we measured the child's behaviour and we found that parents reported child behaviour problems on the domains of social and attention behaviour . In this secondary analysis of the study data, we examined whether maternal psychological distress after severe HDP was related to child social and attention problems at the age of 12 years.…”

Section: Introductionmentioning

confidence: 99%

Maternal psychological distress after severe pregnancy hypertension was associated with increased child behavioural problems at the age of 12

et al. 2019

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Aim: We examined the association between early maternal psychological distress after severe hypertensive disorders of pregnancy (HDP) and behavioural issues in their 12-yearold offspring.Methods: This secondary analyses of a prospective mother-child birth cohort focused on 95 women with severe HDP and their singleton offspring. The mothers were recruited during pregnancy from 2000 to 2003 in Amsterdam, the Netherlands. Maternal distress at child term age and three months post-term was measured using the Symptom Checklist-90. The Child Behaviour Checklist for six years to 18 years was used to quantify social and attention problems in their offspring at 12 years of age. Perinatal and neonatal risk factors were also analysed.Results: The children were born at a mean age of just under 32 weeks and 90% weighed below the 10th percentile. High psychological distress (score ≥133) affected 45% of the mothers at term age and 44% three months post-term. Child social problems were significantly associated with maternal distress at three months and were highest in cases of high maternal distress in combination with major neonatal morbidity. Child attention problems were associated with maternal anxiety at three months post-term.Conclusion: Early maternal psychological distress after severe maternal HDP was associated with childhood behavioural issues at the age of 12.

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Fetal Growth Restriction with Brain Sparing: Neurocognitive and Behavioral Outcomes at 12 Years of Age

Cited by 29 publications

References 45 publications

School Age Neurological and Cognitive Outcomes of Fetal Growth Retardation or Small for Gestational Age Birth Weight

School Age Neurological and Cognitive Outcomes of Fetal Growth Retardation or Small for Gestational Age Birth Weight

Impact of Intrauterine Growth Restriction on Cognitive and Motor Development at 2 Years of Age

Maternal psychological distress after severe pregnancy hypertension was associated with increased child behavioural problems at the age of 12

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