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Growth and neurodevelopment outcome in symmetric versus asymmetric small for gestational age term infants

E Maciejewski1, I Hamon1,2, J Fresson3

  • 1Department of Neonatology, Maternité Régionale, CHRU Nancy, Nancy, France.

Journal of Perinatology : Official Journal of the California Perinatal Association
|March 25, 2016
PubMed

Insights

Asymmetric small for gestational age (SGA) infants showed better catch-up growth and head circumference compared to symmetric SGA infants. Close follow-up is crucial for all SGA infants to improve neurodevelopmental outcomes.

Area of Science:

  • Neonatalogy
  • Pediatric Growth and Development

Background:

  • Small for gestational age (SGA) infants are at risk for adverse outcomes.
  • Limited data exists comparing growth and neurodevelopment between asymmetric (aSYM) and symmetric (SYM) SGA term infants.

Purpose of the Study:

  • To compare the growth and neurodevelopmental outcomes at 9 months of age in asymmetric versus symmetric SGA term infants.

Main Methods:

  • A cohort study of infants born in 2010-2011 with birth weight <5th centile.
  • Infants were classified as SYM (head circumference <5th centile) or aSYM (head circumference ≥5th centile).
  • Catch-up growth and neurodevelopment (Brunet-Lezine test) were assessed at 9 months postnatal age.

Main Results:

  • Of 194 SGA infants, 61.3% were aSYM and 38.7% were SYM.
  • The aSYM group exhibited significantly better catch-up growth (85% vs. 70%, P=0.03) and larger head circumference (44.9±1.6 vs. 43.7±1.2 cm, P<0.0001).
  • No neurodevelopmental differences were found between SGA groups, but lack of catch-up growth correlated with higher risk of delayed outcomes.

Conclusions:

  • Asymmetric SGA infants demonstrate superior catch-up growth compared to symmetric SGA infants.
  • All term SGA infants require close monitoring to optimize their developmental trajectory.
  • Early identification and intervention for SGA infants are critical for improved long-term health.
Abstract

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