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Cognitive function after intrauterine growth restriction and very preterm birth
Eva Morsing1, Malena Asard, David Ley
1Department of Pediatrics, Lund University, Lund, Sweden. eva.morsing@med.lu.se
Pediatrics
|March 9, 2011
Summary
Children born very preterm with intrauterine growth restriction (IUGR) face higher risks for cognitive impairment. This cognitive deficit was particularly pronounced in boys, indicating heightened vulnerability.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Obstetrics
Background:
- Intrauterine growth restriction (IUGR) with absent or reversed end-diastolic blood flow in the umbilical artery is a significant concern in high-risk pregnancies.
- Very preterm birth (<32 weeks gestation) is associated with neurodevelopmental challenges.
- The combined impact of IUGR and very preterm birth on long-term cognitive outcomes requires further investigation.
Purpose of the Study:
- To assess the cognitive outcomes at 5 to 8 years of age in children born very preterm with IUGR.
- To compare cognitive function between preterm infants with IUGR, preterm infants appropriate-for-gestational age (PT-AGA), and term infants appropriate-for-gestational age (T-AGA).
Main Methods:
- A cohort of 34 very preterm infants with IUGR (PT-IUGR) was compared to 34 matched PT-AGA infants and 34 T-AGA infants.
- Cognitive abilities were evaluated using the Wechsler Preschool and Primary Scale of Intelligence and Wechsler Intelligence Scale for Children.
- Behavioral and attention-deficit disorder (ADD) scales were also administered.
Main Results:
- The PT-IUGR group exhibited significantly lower verbal IQ (VIQ) and full-scale IQ (FSIQ) scores compared to both PT-AGA and T-AGA groups.
- Performance IQ (PIQ) was lower in both preterm groups compared to the T-AGA group, but did not differ between PT-IUGR and PT-AGA.
- Boys in the PT-IUGR group showed significantly lower VIQ and FSIQ scores than girls in the same group.
Conclusions:
- Very preterm birth following IUGR increases the risk of cognitive impairment in early school years.
- Cognitive deficits appear more pronounced in boys, suggesting a specific vulnerability to the combined effects of IUGR and preterm birth.
- Behavioral outcomes did not differ between preterm groups, indicating that cognitive function is more significantly impacted.
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