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

Abstract

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.

History of Small for Gestational Age at Birth With Verbal and Non-verbal Intelligence; A Case-Control Study Among Preschool Children

“…These interventions may mask the defects of adverse effects of SGA birth. Our findings support former investigations that reported no significant relationship between adverse effects of SGA status on cognitive-developmental problems such as verbal complications in preschool children ( 10 , 20 ). On the other hand, Sommerfelt et al indicated three times lower verbal IQ points among SGA children when compared with their AGA counterparts.…”

“…These complications related to childhood inattention and executive functions among children born with SGA and low birth weight were also demonstrated in our previous study ( 6 ). Another survey by Hubert et al presented that a history of SGA at birth significantly decreased the non-verbal intelligence score among 50-months old aged children ( 10 ). Another study also demonstrated that assessing non-verbal skills (Performance scales using WISC-test) in 50 children aged ten years old, SGA children had lower scores than the controls regarding Performance scales ( 22 ).…”

“…On the other hand, several investigations have shown that SGA children are not more prone to adverse neurodevelopmental outcomes than children born with appropriate for gestational age (AGA) ( 8 , 9 ). Hubert et al demonstrated no differences between AGA and SGA groups regarding incidences of behavioral disorders, hyperactivity, or cerebral palsy ( 10 ).…”