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

Abstract

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.

Neonatal developmental and behavioral outcomes of immediate delivery versus expectant monitoring in mild hypertensive disorders of pregnancy: 5-year outcomes of the HYPITAT II trial

“…The small range of gestational ages might have contributed to the lack of a significant relation. In literature both fetal growth restriction and birth weight are associated with poor neurodevelopment [31,32]. Our 2-year follow-up study found birth weight as a predictor of development in consensus with literature.…”

Growth and Neurodevelopment of HIV-Exposed Uninfected Children: a Conceptual Framework

“…Prematurity and small-for-gestational age (SGA) are consistently associated with poor postnatal growth and development [55, 56]. Premature infants are vulnerable to prolonged hospitalisation and are at greater risk for neonatal infection and sepsis [57].…”

Maternal and Neonatal Outcome after the Use of G-CSF for Cancer Treatment during Pregnancy

“…In addition to this series, no significant difference in incidence of behavioral problems, asthma, eczema, or problems with speech were found between 29 exposed children, with a mean follow-up of 54 months, and 114 non-exposed children [ 12 ]. Of note, available data are still too limited to make robust conclusions and highlights the need for continuous follow-up, especially as children born SGA seems to be at risk for neurological dysfunction [ 47 ].…”