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Neurocognitive development of children born small for gestational age (SGA). An update

Beatriz Puga1, Paloma Gil, Antonio de Arriba

  • 1Andrea Prader Foundation, IACS (Instituto de Ciencias de La Salud - Institute of Health Sciences), Government of Aragon.

Pediatric Endocrinology Reviews : PER
|January 12, 2013
PubMed

Insights

Children born small for gestational age (SGA) face significant neurocognitive development risks. Catch-up growth offers some protection, but growth hormone therapy shows no benefit in improving outcomes.

Area of Science:

  • Pediatric Endocrinology
  • Neurodevelopmental Pediatrics
  • Child Psychology

Background:

  • Being born small for gestational age (SGA) is a recognized concern.
  • Long-term neurocognitive outcomes for SGA children require further investigation.
  • The impact of catch-up growth and growth hormone (GH) therapy on neurodevelopment is not fully elucidated.

Purpose of the Study:

  • To confirm that being born SGA poses a significant risk for negative neurocognitive development.
  • To evaluate the influence of catch-up growth status on neurocognitive outcomes in SGA children.
  • To assess the efficacy of growth hormone (GH) therapy in mitigating neurocognitive deficits in SGA individuals.

Main Methods:

  • Longitudinal follow-up of 233 SGA cases, with some assessed up to 11 times.
  • Yearly neurocognitive assessments conducted by a single investigator.
  • Categorization of participants into catch-up growth positive (catch-up +) and negative (catch-up -) groups.
  • Analysis of IQ scores relative to standard deviations (SD).

Main Results:

  • 25.8% of SGA children exhibited an IQ less than 2 SD below the mean.
  • Children in the catch-up + group showed a lower incidence of low IQ (15%) compared to the catch-up - group (31.4%).
  • Growth hormone (GH) therapy, regardless of initiation age (before or after 6 years), did not improve neurocognitive outcomes.

Conclusions:

  • Being born SGA is a significant risk factor for impaired neurocognitive development.
  • Catch-up growth may offer a protective effect against severe neurocognitive deficits in SGA children.
  • Growth hormone therapy does not appear to enhance neurocognitive development in this SGA cohort.

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