Neurodevelopmental consequences of being born SGA

Fetal growth retardation is associated with postnatal growth retardation and cardio-vascular and metabolic problems later on in life. Less well described are the consequences of neurodevelopmental outcome. The term SGA is associated with mild to moderate school problems, still present in late puberty and with lower psychological and intellectual performance in young adulthood as compared with AGA controls. Also after preterm SGA birth, neurodevelopmental sequelae are more complex than after preterm AGA birth. Recent volumetric MRI studies of the brain show reduced cortical grey matter volume as one of the most important features of fetal growth retardation. In addition, the hippocampus appears to be especially susceptible to the effects of placental insufficiency. Although growth hormone treatment of children with short stature after SGA birth has been shown to increase head circumference, no clinically significant psychological improvement has been demonstrated after growth hormone treatment to date.