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Term infants with fetal growth restriction are not at increased risk for low intelligence scores at age 17 years
1Department of Pediatrics, Maimonides Medical Center, Brooklyn, New York 11219, USA.
Insights
Infants born small for gestational age (SGA) have slightly lower IQ scores at age 17 compared to appropriate for gestational age (AGA) infants. However, this cognitive difference did not impact academic achievements.
Area of Science:
- Perinatal Medicine
- Developmental Psychology
- Pediatric Neurology
Background:
- Small for gestational age (SGA) is a condition where infants are born with a weight below the 10th percentile for their gestational age.
- Long-term cognitive outcomes for SGA infants are not fully understood, necessitating further research into developmental trajectories.
- Previous studies have yielded mixed results regarding the cognitive impact of SGA, highlighting the need for robust, long-term follow-up data.
Purpose of the Study:
- To evaluate the long-term cognitive performance of term infants born small for gestational age (SGA) compared to those appropriate for gestational age (AGA).
- To determine if being born SGA affects intelligence quotient (IQ) scores and academic achievements in adolescence.
- To identify potential confounding factors influencing cognitive outcomes in SGA individuals.
Main Methods:
- A cohort study utilized data from the Jerusalem Perinatal Study linked with army draft medical board records.
- Infants were categorized as SGA (birth weight <10th percentile) or severe SGA (birth weight <3rd percentile).
- Multiple linear regression analysis controlled for clinical, perinatal, and socio-demographic variables to assess IQ at age 17.
Main Results:
- SGA males exhibited lower adjusted mean IQ scores (102.2) than AGA males (105.1) (P <.0001).
- SGA females also showed lower adjusted mean IQ scores (102.5) compared to AGA females (103.9) (P <.015).
- No significant association was found between SGA status and lower academic achievements at age 17.
Conclusions:
- Term infants born small for gestational age (SGA) demonstrate slightly reduced intelligence test scores at age 17, even after adjusting for confounders.
- The observed cognitive difference between SGA and AGA individuals appears minimal and does not translate into significant differences in academic performance.
- These findings suggest that while SGA may be associated with subtle cognitive variations, its clinical impact on academic success in adolescence is limited.
Objective:
To assess the long-term cognitive outcome of small for gestational age (SGA) compared with appropriate for gestational age (AGA) infants.
Design:
Data from the Jerusalem Perinatal Study was matched with information from the army draft medical board. SGA and severe SGA were defined as birth weight below the 10th and 3rd percentiles for gestational age, respectively. A multiple linear regression analysis was performed to control for clinical, perinatal, and socio-demographic confounding variables.
Subjects:
A cohort of 13,454 consecutive singleton term infants born between 1974 and 1976.
Main Outcome Measure:
IQ at age 17 years.
Results:
SGA infants had lower adjusted mean +/- SE IQ scores compared with their AGA peers: 102.2 +/- 0.9 versus 105.1 +/- 0.7 (P <.0001) for males and 102.5 +/- 0.9 versus 103.9 +/- 0.7 (P <.015) for females. SGA was not associated with lower academic achievements compared with AGA.
Conclusion:
After controlling for multiple confounders, being born SGA at term is associated with slightly lower intelligence test scores at age 17 years. However, the clinical significance of the small difference is not evident in academic achievements.