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Cognitive development of term small for gestational age children at five years of age
K Sommerfelt1, H W Andersson, K Sonnander
1Department of Pediatrics, University of Bergen, Barneklinikken, 5021 Haukeland Sykehus, Norway. ksom@haukeland.no
Insights
Parental factors significantly influence child cognitive development more than being small for gestational age (SGA). Child rearing environment and maternal abilities are key, with SGA status having minimal impact on IQ.
Area of Science:
- Developmental Psychology
- Pediatrics
- Genetics
Background:
- Intrauterine growth restriction, specifically being small for gestational age (SGA), is a concern for cognitive development.
- Parental demographics and the child-rearing environment are also recognized as crucial factors influencing a child's cognitive trajectory.
Purpose of the Study:
- To compare the relative importance of being small for gestational age (SGA) versus parental and environmental factors on cognitive development.
- To investigate the impact of maternal factors and child-rearing styles on the IQ of SGA and appropriate for gestational age (AGA) children.
Main Methods:
- A population-based cohort study compared the IQ at 5 years of age of 338 term infants who were small for gestational age (SGA) without major handicap to 335 appropriate for gestational age (AGA) infants.
- Cognitive development was assessed using IQ tests, and parental demographic and child-rearing factors were analyzed for their influence.
Main Results:
- Children who were small for gestational age (SGA) had slightly lower mean verbal and non-verbal IQ scores compared to appropriate for gestational age (AGA) peers.
- Parental factors, including maternal problem-solving skills and child-rearing style, explained a substantial portion of the variance in IQ (20-30%), while SGA status explained only 1-2%.
- Maternal smoking at conception was associated with a reduction in mean IQ, with a similar effect observed in both SGA and AGA children. No increased sensitivity to the child-rearing environment was found in SGA children.
Conclusions:
- Cognitive development in children is more strongly associated with parental factors and the home environment than with intrauterine growth retardation (SGA status).
- While being small for gestational age (SGA) has a marginal association with cognitive outcomes, parental characteristics play a significantly larger role.
Aim:
To assess the relative significance for cognitive development of small for gestational age, parental demographic factors, and factors related to the child rearing environment.
Methods:
IQ of a population based cohort of 338 term infants who were small for gestational age (SGA) and without major handicap, and a random control sample of 335 appropriate for gestational age (AGA) infants were compared at 5 years of age.
Results:
The mean non-verbal IQ was four points lower, while the mean verbal IQ was three points lower for the children in the SGA group. The results were not confounded by parental demographic or child rearing factors. However, parental factors, including maternal non-verbal problem solving abilities, and child rearing style, accounted for 20% of the variance in non-verbal IQ, while SGA versus AGA status accounted for only 2%. The comparable numbers for verbal IQ were 30 and 1%. Furthermore, we found no evidence that the cognitive development of SGA children was more sensitive to a non-optimal child rearing environment than that of AGA children. Maternal smoking at conception was associated with a reduction in mean IQ comparable to that found for SGA status, and this effect was the same for SGA and AGA children. The cognitive function of asymmetric SGA was comparable to that of symmetric SGA children.
Conclusions:
Our findings indicate that child cognitive development is strongly associated with parental factors, but only marginally associated with intrauterine growth retardation.