Abstract
OBJECTIVES: To examine the association between intrauterine growth restriction and neurodevelopmental outcome among full-term small-for-gestational-age (SGAT) infants at 8 months and 4 years of age.
STUDY DESIGN: Growth parameters at birth and test scores on measures of neurodevelopmental function for 3922 children born SGAT were compared with those of 29,369 children born appropriately grown-for-gestational-age term from similar economic backgrounds. Additional within-SGAT/economic group comparisons were made for 1684 SGAT infants with symmetric undergrowth at birth and 2034 SGAT infants with asymmetric undergrowth at birth.
RESULTS: Regardless of socioeconomic background, infants born SGAT were found to be at significantly increased risk for neurodevelopmental difficulties at 8 months and at 4 years of age. Few within SGAT/socioeconomic group differences in neurodevelopmental outcome appeared to be associated with specific pattern of growth restriction at birth.
CONCLUSIONS: The present findings provide further evidence of the individual and public health impact of SGAT birth.
Similar content being viewed by others
References
Goldenberg RL, Dubard MB, Cliver SP . et al. Pregnancy outcome and intelligence at age five years. Am J Obstet Gynecol 1996;175:1511–1515.
McCarton CM, Wallace IF, Divon M, Vaughan Jr. HG . Cognitive and neurologic development of the premature, small for gestational age infant through age 6: comparison by birth weight and gestational age. Pediatrics 1996;98:1167–1178.
Martikainen MA . Effects of intrauterine growth retardation and its subtypes on the development of the preterm infant. Early Hum Dev 1992;28:7–17.
Matilainen R, Heinonen K, Siren-Tiusanen H . Effect of intrauterine growth retardation (IUGR) on the psychological performance of preterm children at preschool age. J Child Psychol Psychiatry 1988;29:601–609.
Tenovuo A, Kero P, Korvenranta H, Piekkala P, Sillanpaa M, Erkkola R . Developmental outcome of 519 small-for-gestational age children at the age of two years. Neuropediatrics 1988;19:41–45.
Pena IC, Teberg AJ, Finello KM . The premature small-for-gestational-age infant during the first year of life: comparison by birth weight and gestational age. J Pediatr 1988;113:1066–1073.
Matilainen R, Heinonen K, Siren-Tiusanen H, Jokela V, Launiala K . Neurodevelopmental screening of in utero growth-retarded prematurely born children before school age. Eur J Pediatr 1987;146:453–457.
Yamaguchi K, Hara H, Nishida H . et al. Clinical study on intrauterine growth retardation. Part I. Outcome for small-for-gestational-age infants with very low birth weight (less than 1500 g). Acta Paediatr Jpn 1987;29:742–748.
Albertsson-Wikland K, Boguszewski M, Karlberg J . Children born small-for-gestational age: postnatal growth and hormonal status. Horm Res 1998;49 (Suppl 2):7–13.
Hadders-Algra M, Huisjes HJ, Touwen BC . Preterm or small-for-gestational-age infants. Neurological and behavioural development at the age of 6 years. Eur J Pediatr 1988;147:460–467.
Molteno CD, Woods D, Hollingshead J . A 5-year follow-up study of full term small for gestional age infants in Cape Town. Dev Brain Dysfunction 1995;8:119–126.
Walther FJ . Growth and development of term disproportionate small-for-gestational age infants at the age of 7 years. Early Hum Dev 1988;18:1–11.
Watt J, Strongman KT . Mother–infant interactions at 2 and 3 months in preterm, small-for-gestational-age, and full-term infants; their relationship with cognitive development at 4 months. Early Hum Dev 1985;11:231–246.
Bhargava SK, Datta I, Kumari S . A longitudinal study of language development in small-for-dates children from birth to five years. Indian Pediatr 1982;19:123–129.
Sommerfelt K, Andersson HW, Sonnander K . et al. Cognitive development of term small for gestational age children at five years of age. Arch Dis Child 2000;83:25–30.
Fattal-Valevski A, Leitner Y, Kutai M . et al. Neurodevelopmental outcome in children with intrauterine growth retardation: a 3-year follow-up. J Child Neurol 1999;14:724–727.
Harvey D, Prince J, Bunton J, Parkinson C, Campbell S . Abilities of children who were small-for-gestational-age babies. Pediatrics 1982;69:296–300.
Rasmussen S, Irgens LM . Fetal growth and body proportion in preeclampsia. Obstet Gynecol 2003;101:575–583.
Dashe JS, McIntire DD, Santos-Ramos R, Leveno KJ . Impact of head-to-abdominal circumference asymmetry on outcomes in growth-discordant twins. Am J Obstet Gynecol 2000;183:1082–1087.
Harel S, Kutai M, Tomer A . et al. Intrauterine growth retardation: diagnosis and neurodevelopmental outcome. In: Anastasiow NJ, Harel S, editors. Interventions, Families and Research. Baltimore, MD: Brookes; 1993. p. 145–159.
Holt AB, Cheek DB, Mellitis D, Hill DE . Hormones and nutrition. In: Cheek DB, editor. Fetal and Postnatal Cellular Growth. New York: John Wiley Sons; 1975. p. 23–24.
Broman S, Nichols PL, Shaughnessy P, Kennedy W . Retardation in Young Children. New Jersey: Hillsdale; 1987.
Sever LE, Olsen AR, Hinds NR, Watson CR, Perrin EB, Littlefield JS . NINCDS Collaborative Perinatal Project: a user's guide to the project and data. Volume I: An Introduction to the History, Scope and Methodology of the Project. Washington, DC: Battelle; 1983.
Niswander KR, Gordon MJ . National Institute of Neurological Diseases and Stroke. The Women and Their pregnancies the Collaborative Perinatal Study of the National Institute of Neurological Diseases and Stroke. Washington, DC: National Institute of Health; 1972.
Daniels JL, Longnecker MP, Klebanoff MA . et al. Prenatal exposure to low-level polychlorinated biphenyls in relation to mental and motor development at 8 months. Am J Epidemiol 2003;157:485–492.
Gilman SE, Kawachi I, Fitzmaurice GM, Buka SL . Socioeconomic status in childhood and the lifetime risk of major depression. Int J Epidemiol 2002;31:359–367.
Seidman LJ, Buka SL, Goldstein JM, Horton NJ, Rieder RO, Tsuang MT . The relationship of prenatal and perinatal complications to cognitive functioning at age 7 in the New England Cohorts of the National Collaborative Perinatal Project. Schizophr Bull 2000;26:309–321.
Strauss RS, Dietz WH . Growth and development of term children born with low birth weight: effects of genetic and environmental factors. J Pediatr 1998;133:67–72.
Broman S . The collaborative perinatal project: an overview. In: Mednick SA, Harvey M, Finello, editors. Handbook of Longitudinal Research. New York: Praegar; 1984. p. 185–215.
Brazelton TB, Parker WB, Zuckerman B . Importance of behavioral assessment of the neonate. In: Gluck L, editor. Current Problems in Pediatrics. Chicago: Year Book Medical Publishers; 1976. p. 1–82.
Peleg D, Kennedy CM, Hunter SK . Intrauterine growth restriction: identification and management. Am Fam Physician 1998;58:453–457.
Klaus MH, Fanaroff AA . Care of the high risk neonate. Philadelphia: WB Sanders; 1986.
Bayley N . Bayley Scales of Infant Development. New York: Psychological Corporation; 1969.
Terman LM, Merrill MA . Stanford–Binet Intelligence Scale: Manual for the Third Revision form L-M. Boston: Houghton Mifflin; 1960.
Frisk V, Amsel R, Whyte HE . The importance of head growth patterns in predicting the cognitive abilities and literacy skills of small-for-gestational-age children. Dev Neuropsychol 2002;22:565–593.
Lundgren EM, Cnattingius S, Jonsson B, Tuvemo T . Intellectual and psychological performance in males born small for gestational age with and without catch-up growth. Pediatr Res 2001;50:91–96.
Gutbrod T, Wolke D, Soehne B, Ohrt B, Riegel K . Effects of gestation and birth weight on the growth and development of very low birthweight small for gestational age infants: a matched group comparison. Arch Dis Child Fetal Neonatal Ed 2000;82:F208–F214.
SAS Institute Inc. Statistical Analysis Software (SAS). Version 8.0. Cary, NC: SAS Institute Inc.; 1999.
Watt J . Interaction and development in the first year. II. The effects of intrauterine growth retardation. Early Hum Dev 1986;13:211–223.
Pryor JE . Physical and developmental status of preschool small-for-gestational-age children: a comparative study. J Paediatr Child Health 1992;28:162–167.
Low JA, Galbraith RS, Muir D, Killen H, Karchmar J, Campbell D . Intrauterine growth retardation: a preliminary report of long-term morbidity. Am J Obstet Gynecol 1978;130:534–545.
Ounsted M, Moar VA, Scott A . Neurological development of small-for-gestational age babies during the first year of life. Early Hum Dev 1988;16:163–172.
Brown JL, Pollitt E . Malnutrition, poverty and intellectual development. Sci Am 1996;274:38–43.
Watemberg N, Silver S, Harel S, Lerman-Sagie T . Significance of microcephaly among children with developmental disabilities. J Child Neurol 2002;17:117–122.
Cuttini M, Cortinovis I, Bossi A, de Vonderweid U . Proportionality of small for gestational age babies as a predictor of neonatal mortality and morbidity. Paediatr Perinat Epidemiol 1991;5:56–63.
Parkinson CE, Scrivener R, Graves L, Bunton J, Harvey D . Behavioural differences of school-age children who were small-for-dates babies. Dev Med Child Neurol 1986;28:498–505.
Chamberlain G . ABC of antenatal care. Small for gestational age. BMJ 1991;302:1592–1596.
Cnattingious S . The small-for-gestational-age infant: obstetric management and perinatal outcome. Upsala J of Med Sci 1989, 55–65.
Ounsted M, Moar VA, Scott A . Small-for-dates babies, gestational age, and developmental ability at 7 years. Early Hum Dev 1989;19:77–86.
Wennergren M, Wennergren G, Vilbergsson G . Obstetric characteristics and neonatal performance in a four-year small for gestational age population. Obstet Gynecol 1988;72:615–620.
Kullberg G, Lindeberg S, Hanson U . Eclampsia in Sweden. Hypertens Pregnancy 2002;21:13–21.
Brodszki J, Marsal K . Management of pregnancies with suspected intrauterine growth retardation in Sweden. Results of a questionnaire. Acta Obstet Gynecol Scand 2000;79:723–728.
Chaussain JL, Colle M, Landier F . Effects of growth hormone therapy in prepubertal children with short stature secondary to intrauterine growth retardation. Acta Paediatr Suppl 1994;399:74–75.
de Zegher F, Maes M, Gargosky SE . et al. High-dose growth hormone treatment of short children born small for gestational age. J Clin Endocrinol Metab 1996;81:1887–1892.
Lee PA, Chernausek SD, Hokken-Koelega AC, Czernichow P . International Small for Gestational Age Advisory Board consensus development conference statement: management of short children born small for gestational age, April 24–October 1, 2001. Pediatrics 2003;111:1253–1261.
Castillo-Duran C, Rodriguez A, Venegas G, Alvarez P, Icaza G . Zinc supplementation and growth of infants born small for gestational age. J Pediatr 1995;127:206–211.
Olivares M, Llaguno S, Marin V, Hertrampf E, Mena P, Milad M . Iron status in low-birth-weight infants, small and appropriate for gestational age. A follow-up study. Acta Paediatr 1992;81:824–828.
Sazawal S, Black RE, Menon VP . et al. Zinc supplementation in infants born small for gestational age reduces mortality: a prospective, randomized, controlled trial. Pediatrics 2001;108:1280–1286.
Watt J . Interaction, intervention, and development in small-for-gestational-age infants. Infant Behav Dev 1990, 273–286.
Beeghly M, Brazelton TB, Flannery KA, Nugent JK, Barrett DE, Tronick EZ . Specificity of preventative pediatric intervention effects in early infancy. J Dev Behav Pediatr 1995;16:158–166.
Dowling M, Bendell-Estroof D . The impact of small for gestational age birth status upon premature children. Children's Health Care 1991;20:138–143.
Zeskind PS, Ramey CT . Fetal malnutrition: an experimental study of its consequences on infant development in two caregiving environments. Child Dev 1978;49:1155–1162.
Author information
Authors and Affiliations
Appendix A
Appendix A
See Table A1
Rights and permissions
About this article
Cite this article
Jelliffe-Pawlowski, L., Hansen, R. Neurodevelopmental Outcome at 8 Months and 4 Years among Infants Born Full-Term Small-for-Gestational-Age. J Perinatol 24, 505–514 (2004). https://doi.org/10.1038/sj.jp.7211111
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.jp.7211111
- Springer Nature America, Inc.
This article is cited by
-
Small-for-Gestational-Age and Vocabulary and Achievement Test Scores at Age 9 Among Children Born at Term in a Contemporary U.S. Sample
Maternal and Child Health Journal (2023)
-
A review of infant growth and psychomotor developmental outcomes after intrauterine exposure to preeclampsia
BMC Pediatrics (2022)
-
Impact of size at birth and postnatal growth on metabolic and neurocognitive outcomes in prematurely born school-age children
Scientific Reports (2021)
-
Association between small-for-gestational age and neurocognitive impairment at two years of corrected age among infants born at preterm gestational ages: a cohort study
Journal of Perinatology (2017)
-
Growth and neurodevelopment outcome in symmetric versus asymmetric small for gestational age term infants
Journal of Perinatology (2016)