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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
Functional outcomes at age 7 years of moderate preterm and full term children born small for gestational age
Jozien C Tanis1, Koenraad N J A Van Braeckel1, Jorien M Kerstjens1
1Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Insights
Children born small for gestational age (SGA) show similar school-age outcomes to appropriate for gestational age (AGA) peers, except for a higher risk of attention control issues. These differences appear to have limited impact but warrant attention for school performance.
Area of Science:
- Pediatric Health
- Developmental Psychology
- Neonatal Research
Background:
- Children born small for gestational age (SGA) may experience altered neurodevelopmental trajectories.
- Understanding functional outcomes in school-aged SGA children is crucial for identifying potential long-term challenges.
Purpose of the Study:
- To compare functional outcomes at school age between children born small for gestational age (SGA) and appropriate for gestational age (AGA).
- To investigate differences in cognitive, motor, and executive functions between SGA and AGA children born moderately preterm or full term.
Main Methods:
- Prospective cohort study involving 336 AGA and 42 SGA children.
- Assessment at approximately 7 years of age included intelligence, memory, attention, visuomotor integration, and motor skills.
- Parent-reported executive functioning was also collected.
Main Results:
- SGA children demonstrated similar performance to AGA peers across most assessed domains.
- A significantly higher prevalence of abnormal attention control was observed in SGA children (OR 3.99).
- IQ scores were marginally lower in SGA children, but this difference did not reach statistical significance.
Conclusions:
- Children born SGA face an elevated risk of attention control deficits at school age, irrespective of gestational age.
- Motor skills and other cognitive functions are largely comparable between SGA and AGA children.
- While the overall impact appears limited, the implications for academic performance merit consideration.
Objective:
To compare functional outcomes of 7-year-old (school-age) children born small for gestational age (SGA; ie, a birth weight z score ≤ -1 SD), with appropriate for gestational age (AGA) peers, born moderately preterm or full term.
Study Design:
Data were collected as part of the Longitudinal Preterm Outcome Project study, a community-based, prospective cohort study of 336 AGA and 42 SGA born children (median gestational age 35 weeks, range 31-41). Of the SGA children, 32 were moderately preterm, 10 were full term; of the AGA, these numbers were 216 and 120, respectively. At 6.9 years, we assessed intelligence, verbal memory, attention, visuomotor integration, and motor skills and we collected the parent-reported executive functioning. We compared the outcomes of the SGA children with those of their AGA peers.
Results:
The performance of SGA children was similar to that of their AGA peers, except for attention control which was abnormal more often in SGA children (OR 3.99, 95% CI 1.32-12.12). The IQ of SGA children was 3 points lower, but this difference failed to reach significance.
Conclusions:
At school age, children born SGA have a greater risk of abnormal test scores on attention control than children born AGA, independent of gestational age. Their motor and many other cognitive functions are similar. The impact of these outcomes seems limited. Nevertheless, the consequences for school performance deserve attention.
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