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Intrauterine growth and neuropsychological performance in very low birth weight preschoolers
Sarah Raz1, Angela K Debastos, Julie Bapp Newman
1Department of Psychology and the Merrill Palmer Skillman Institute, Wayne State University, Detroit, Michigan 48202, USA. sarahraz@wayne.edu
Insights
Intrauterine growth impacts preschooler development. Appropriate growth, even in very low birth weight infants, is linked to better cognitive and motor skills, highlighting its importance for neurodevelopmental outcomes.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Intrauterine growth is a critical factor in fetal development.
- Very low birth weight (VLBW) infants are at risk for neurodevelopmental challenges.
- Understanding the impact of intrauterine growth on neuropsychological outcomes in VLBW populations is crucial.
Purpose of the Study:
- To investigate the association between intrauterine growth and neuropsychological outcomes in VLBW preschoolers.
- To determine if different methods of indexing intrauterine growth yield different associations with neurodevelopmental measures.
Main Methods:
- A sample of 143 VLBW preschoolers was assessed.
- Intrauterine growth was indexed categorically (10th percentile cutoff for IUGR) and continuously (standardized birth weight).
- Neuropsychological outcomes, including cognitive, visuospatial, and motor skills, were evaluated.
Main Results:
- Categorical IUGR classification (<10th percentile) was associated with poorer global motor skills only.
- Continuous assessment of birth weight explained unique variance in global cognition, visuospatial skills, and all motor domains.
- The association between intrauterine growth adequacy and cognitive abilities remained significant even after excluding IUGR cases.
Conclusions:
- The method of indexing intrauterine growth significantly influences observed associations with neuropsychological outcomes.
- Adequacy of intrauterine growth, assessed continuously, is a significant predictor of cognitive and motor development in VLBW preschoolers.
- Appropriate intrauterine growth may be protective for neurodevelopmental outcomes even within the VLBW population.
Abstract:
In this study we examined the association between intrauterine growth, indexed either as a categorical variable or continuous dimension, and neuropsychological outcome, in a very low birth weight (VLBW) sample of 143 preschoolers. When the commonly used split at the 10th percentile rank was applied to classify intrauterine growth restriction (IUGR), we found that the growth restricted group (n = 25) exhibited significantly poorer performance in the global motor domain, but not on any other neuropsychological measure. In contrast, when adequacy of intrauterine growth was indexed by standardized birth weight, a continuous dimension, this early risk factor explained a unique portion of the variance in global cognitive abilities and visuospatial skills, as well as in global, fine, and gross motor skills. These findings are consistent with recent magnetic resonance imaging data disclosing global neurodevelopmental changes in the brains of preterm infants with IUGR. When cases classified with IUGR (<10th percentile) were excluded, the relationship between adequacy of intrauterine growth and global cognitive abilities remained significant despite range restriction. Hence, an association between appropriateness of intrauterine growth and global intellectual outcome may be observed even within the population of VLBW preschoolers with adequate standardized birth weight.
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