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Extremely preterm infants small for gestational age are at risk for motor impairment at 3 years corrected age
Takeshi Kato1, Tsurue Mandai1, Sota Iwatani1
1Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
Insights
Extremely preterm infants born severely small for gestational age (SGA) face risks in motor development. Early gestational age is a key factor in developmental delays for these very low birth weight (VLBW) infants.
Area of Science:
- Neonatalogy
- Developmental Pediatrics
- Perinatal Medicine
Background:
- Limited research exists on psychomotor development in Japanese very low birth weight (VLBW) infants who are severely small for gestational age (SGA).
- Understanding perinatal risk factors is crucial for this vulnerable population.
Purpose of the Study:
- To investigate psychomotor development in Japanese VLBW infants born severely SGA.
- To identify associated perinatal risk factors and developmental outcomes at 3 years corrected age.
Main Methods:
- A single-center study of 104 Japanese VLBW infants (born 2000-2007) with severe SGA.
- Psychomotor development assessed using the Kyoto Scale of Psychological Development at 3 years corrected age.
- Infants categorized by gestational age (>=28 weeks vs. <28 weeks) and compared to appropriate for gestational age (AGA) peers.
Main Results:
- In infants born at >=28 weeks gestation, severe SGA did not significantly impact DQ compared to AGA infants.
- However, infants born at <28 weeks gestation with severe SGA showed significantly lower postural-motor DQ than AGA infants.
- Gestational age <28 weeks was an independent predictor of low postural-motor DQ, irrespective of SGA cause.
Conclusions:
- Extremely preterm newborns who are also severely SGA are at heightened risk for motor developmental disabilities by age 3.
- Gestational age at birth is a critical factor influencing motor outcomes in this cohort.
Background:
Few studies have targeted psychomotor development and associated perinatal risk factors in Japanese very low birth weight (VLBW) infants who are severely small for gestational age (SGA).
Design/Subjects:
A single-center study was conducted in 104 Japanese VLBW infants who were born preterm, due to maternal, umbilical cord, or placental abnormalities, between 2000 and 2007. Psychomotor development as a developmental quotient (DQ) was assessed using the Kyoto Scale of Psychological Development at 3 years corrected age. Severely SGA was defined as birth weight or length below -2 standard deviation values of the mean values at the same gestation. VLBW infants were divided into 2 subgroups based on gestational age at birth: ⩾28 weeks (n=64) and <28 weeks (n=40). DQs of infants with severe SGA were compared with those of infants who were appropriate for gestational age (AGA). Factors associated with developmental disabilities in VLBW infants with severe SGA (n=23) were determined.
Results:
In the group born at ⩾28 weeks gestation, infants with severe SGA had normal DQ values and did not significantly differ from those with AGA. However, in the group born at <28 weeks gestation, severe SGA infants had significantly lower postural-motor DQ values than AGA infants. Gestational age <28 weeks was an independent factor for low postural-motor DQ, regardless of the cause of severe SGA or pregnancy termination.
Conclusions:
Extremely preterm newborns with severe SGA are at risk of motor developmental disability at age 3 years.
