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Axonal loss and cognitive deficits in term infants with normal umbilical artery Doppler born small-for-gestational
1Ophthalmology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain. vpueyo@unizar.es
Insights
Children born small-for-gestational age (SGA) with normal umbilical artery (UA) Doppler show reduced neuronal integrity and cognitive deficits. These findings highlight increased risks for axonal loss in the retinal nerve fiber layer (RNFL) and impaired visuospatial skills by early school age.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Ophthalmology
Background:
- Infants born small-for-gestational age (SGA) may experience long-term neurodevelopmental challenges.
- Assessing central nervous system structural changes, particularly neuronal integrity, offers insights into developmental outcomes.
- Optical coherence tomography (OCT) provides a novel method to evaluate optic nerve health.
Purpose of the Study:
- To investigate cognitive outcomes in term-born children small-for-gestational age (SGA) with normal umbilical artery (UA) Doppler.
- To assess structural changes in the central nervous system, specifically neuronal integrity of the optic nerve, in this cohort.
- To correlate neurodevelopmental assessments with optic nerve structural integrity.
Main Methods:
- Comparison of two groups: infants born SGA (n=40) and appropriate-for-gestational age (AGA) (n=39).
- Neuronal damage evaluated using optical coherence tomography (OCT) of the optic nerve, measuring retinal nerve fiber layer (RNFL) thickness.
- Cognitive function assessed via Wechsler Preschool and Primary Scale of Intelligence (WPPSI) and visuospatial perception via Rey-Osterreich Complex Figure (ROCF) tasks.
Main Results:
- Children born SGA exhibited significantly thinner average RNFL thickness compared to AGA controls (98.2 vs 104.5 µm, P=0.012).
- SGA group showed impaired performance on ROCF copy tasks (3.27 vs 3.56, P=0.036).
- A higher rate of suboptimal WPPSI intelligence quotient scores was observed in the SGA group (15% vs 0%, P=0.025).
Conclusions:
- Term infants born SGA with normal UA Doppler are at increased risk for cognitive deficits.
- These infants also demonstrate evidence of axonal loss in the RNFL.
- Findings suggest a need for early monitoring and potential interventions for neurodevelopmental outcomes in SGA infants.
Objective:
To assess cognitive outcomes and structural changes in the central nervous system, the latter using a novel approach to examine changes in neuronal integrity of the optic nerve, in children at 5-6½ years of age who were born small-for-gestational age (SGA) at term having shown normal umbilical artery (UA) Doppler.
Methods:
We compared neuronal damage, cognitive deficits and visuospatial perception in two cohorts of infants, one born SGA (n = 40) and one born appropriate-for-gestational age (AGA) (n = 39) in weight. Neuronal damage was evaluated using optical coherence tomography (OCT) of the optic nerve. Cognitive deficits were assessed with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) test. Visuospatial perception was evaluated with Rey-Osterreich Complex Figure (ROCF) tasks.
Results:
Children from the SGA group had a significantly thinner average retinal nerve fiber layer (RNFL) compared with those from the AGA group (98.2 vs 104.5 µm, P = 0.012). Children from the SGA group exhibited impaired performance in copy tasks on the ROCF (3.27 vs 3.56, P = 0.036) and a higher rate of suboptimal WPPSI test performance intelligence quotient scores (15% vs 0%; P = 0.025) compared with those from the AGA group.
Conclusion:
Term infants with normal UA Doppler born SGA are at increased risk for cognitive deficits and axonal loss in the RNFL at the age of 5-6½ years.
