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Published on: August 25, 2014
Neurodevelopment in full-term small for gestational age infants: A nationwide Japanese population-based study
Akihito Takeuchi1, Takashi Yorifuji2, Kyohei Takahashi3
1Department of Neonatology, Okayama Medical Center, National Hospital Organization, Okayama, Japan.
Insights
Small for gestational age (SGA) infants, even those born full-term, face higher risks of developmental delays. This study highlights the significant public health impact of SGA, emphasizing the need for early intervention and support.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Public Health
Background:
- Small for gestational age (SGA) infants are at increased risk for adverse outcomes.
- Neurological development in full-term SGA infants requires further investigation.
Purpose of the Study:
- To investigate neurological development in small for gestational age (SGA) infants.
- To specifically focus on the developmental trajectory of full-term SGA infants.
Main Methods:
- Analysis of a large, Japanese, nationwide, population-based longitudinal survey data (n=46,563).
- Assessment of motor, language, and behavioral development at 2.5 and 5.5 years.
- Logistic regression analysis to determine the relationship between SGA status and developmental outcomes, adjusting for confounding factors.
Main Results:
- Full-term SGA infants showed increased likelihood of developmental delays at 2.5 years, including walking alone (OR 3.0) and sentence formation (OR 1.5).
- SGA status was associated with behavioral problems at 5.5 years, such as difficulty with sustained attention (OR 1.2) and patience (OR 1.1).
- Public health impacts of SGA were comparable between full-term and preterm infants at 2.5 years.
Conclusions:
- Small for gestational age (SGA) is a significant risk factor for developmental delays, even in full-term infants.
- These findings underscore the non-negligible public health implications of SGA births.
Objective:
To investigate neurological development in small for gestational age (SGA) infants, with a focus on full-term SGA infants.
Methods:
We analyzed data from a large, Japanese, nationwide, population-based longitudinal survey started in 2001. We restricted the study to participants born before 42weeks of gestation (n=46,563). Parents were asked questions about motor and language development when the children were 2.5years old, and about behavioral development at 5.5years. We analyzed the relationships between SGA status and development by logistic regression. Odds ratios (ORs) and 95% confidence intervals (95% CI) were calculated for each outcome for full-term and preterm births, adjusting for potential infant- and parent-related confounding factors. We also calculated the population-attributable fractions to estimate the public impact of SGA births.
Results:
SGA full-term children were more likely to demonstrate developmental delays at 2.5years, e.g., being unable to walk alone (OR 3.0, 95% CI: 1.7, 5.3), compose a two-phrase sentence (OR 1.5, 95% CI: 1.2, 1.8), or use a spoon to eat (OR 1.5, 95% CI: 1.1, 1.9). SGA status also had some degree of negative impacts on behavioral problems at 5.5years among term children, e.g., being unable to listen without fidgeting (OR 1.2, 95% CI: 1.1, 1.3), or remain patient (OR 1.1, 95% CI: 1.0, 1.2). The public health impacts were comparable between full-term and preterm SGA children at 2.5years.
Conclusion:
SGA is a risk factor for developmental delay, even in full-term infants, with non-negligible public health impacts.
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