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Fetal growth, cognitive function, and brain volumes in childhood and adolescence
Tormod Rogne1, Andreas Aass Engstrøm, Geir Wenberg Jacobsen
1Departments of Public Health and General Practice and Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, and the Department of Obstetrics, St. Olav's University Hospital, Trondheim, and the Department of Pediatrics, Sørlandet Hospital, Arendal, Norway.
Insights
Children born small-for-gestational-age (SGA) with fetal growth restriction showed lower cognitive scores and smaller brain volumes. These findings highlight the long-term impact of decelerated fetal growth on neurodevelopment.
Area of Science:
- Neuroscience
- Developmental Biology
- Pediatrics
Background:
- Fetal growth patterns can influence long-term neurodevelopmental outcomes.
- Small-for-gestational-age (SGA) is a common indicator of suboptimal fetal growth.
- Understanding the impact of fetal growth restriction on cognitive function and brain development is crucial.
Purpose of the Study:
- To investigate the association between fetal growth patterns and cognitive function at ages 5 and 9.
- To examine the relationship between fetal growth patterns and regional brain volumes at age 15.
- To differentiate the effects of SGA with and without fetal growth restriction.
Main Methods:
- Longitudinal follow-up of 83 term-born SGA neonates and 105 controls.
- Classification of SGA neonates based on serial fetal ultrasound measurements (gestational weeks 25-37).
- Assessment of cognitive function (IQ) at 5 and 9 years; estimation of brain volumes via MRI at 15 years.
Main Results:
- SGA children had lower performance IQ at 5 years compared to controls.
- Children with SGA and fetal growth restriction showed significantly lower performance IQ at 5 and 9 years versus controls.
- Significant differences in thalamic and cerebellar white matter volumes were observed at 15 years in the SGA fetal growth restriction group compared to controls.
Conclusions:
- SGA children, particularly those with fetal growth restriction, exhibit deficits in cognitive function and brain development.
- Decelerated fetal growth is associated with reduced intelligence quotient scores and smaller brain volumes in later childhood and adolescence.
- These findings suggest a direct link between fetal growth restriction and long-term neurodevelopmental consequences.
Objective:
To evaluate the association between fetal growth pattern and cognitive function at 5 and 9 years and regional brain volumes at 15 years.
Methods:
Eighty-three term-born small-for-gestational-age (SGA) neonates and 105 non-SGA neonates in a control group were available for follow-up. Based on serial fetal ultrasound measurements from gestational weeks 25-37, SGA neonates were classified with fetal growth restriction (n=13) or non-fetal growth restriction (n=36). Cognitive function was assessed at 5 and 9 years, and brain volumes were estimated with cerebral magnetic resonance imaging at 15 years.
Results:
Small-for-gestational-age children had lower performance intelligence quotient at 5 years compared with those in a control group (107.3 compared with 112.5, P<.05). Although there were no differences between the SGA non-fetal growth restriction and control groups, the SGA fetal growth restriction group had significantly lower performance intelligence quotient at 5 years (103.5 compared with 112.5, P<.05) and 9 years (96.2 compared with 107.5, P<.05) compared with those in the control group. There were some brain volume differences at 15 years between SGA children and those in the control group, but after adjustment for total intracranial volume, age at examination, and sex, there were only significant differences between the SGA fetal growth restriction and control groups for thalamic (17.4 compared with 18.6 cm, P<.01) and cerebellar white matter volumes (21.5 compared with 24.3 cm, P<.01).
Conclusion:
Small-for-gestational-age children had lower intelligence quotient scores at 5 and 9 years and smaller brain volumes at 15 years compared with those in the control group, but these findings were only found in those with fetal growth restriction, indicating a possible relationship to decelerated fetal growth.
Level Of Evidence:
II.
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