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Behavioral outcomes of school-aged full-term small-for-gestational-age infants: A nationwide Japanese
Akihito Takeuchi1, Takashi Yorifuji2, Kyohei Takahashi3
1Department of Neonatology, Okayama Medical Center, National Hospital Organization, Okayama, Japan.
Insights
Small for gestational age (SGA) birth is linked to increased attentional problems and aggressive behaviors in school-aged children. Long-term developmental support may be beneficial for these children.
Area of Science:
- Pediatrics
- Developmental Psychology
- Public Health
Background:
- Small for gestational age (SGA) birth is associated with neurological deficits in early childhood.
- Limited evidence exists regarding the persistence of these deficits into school age.
Purpose of the Study:
- To investigate the association between small for gestational age (SGA) birth and behavioral development at school age in full-term infants.
Main Methods:
- Analysis of a large, Japanese, nationwide, population-based longitudinal survey (n=33,795).
- Inclusion of full-term infants (37-41 weeks gestation) with birth weight and 8-year behavioral outcome data.
- Logistic regression used to assess associations between SGA birth and attentional/aggressive behaviors, adjusting for confounders.
Main Results:
- Small for gestational age (SGA) children exhibited higher odds of interrupting others (OR 1.10).
- SGA children were more likely to struggle with waiting their turn (OR 1.17).
- SGA children showed increased odds of destroying toys/books (OR 1.15).
Conclusions:
- Small for gestational age (SGA) birth is negatively associated with specific attentional and aggressive behaviors at school age.
- This large-scale study highlights potential long-term developmental impacts of SGA birth.
- Full-term SGA infants may require ongoing developmental follow-up and support.
Background:
Small for gestational age (SGA) birth is linked with neurological deficits among children at pre-school age, but the evidence is still limited on whether such deficits are still observable at school age. We investigated the association between SGA birth and behavioral development at school age among full-term infants.
Methods:
We analyzed data from a large, Japanese, nationwide, population-based longitudinal survey that started in 2001. We restricted the study participants to children born at 37-41weeks of gestation with information on birth weight and behavioral outcomes at 8years of age (n=33,795). Behavioral outcomes including three attentional problems and four aggressive behaviors queried at 8years of age by survey questions were used as outcome indicators. We then used logistic regression to estimate odds ratios (OR) and 95% confidence intervals (95% CI) for the associations between SGA birth and each outcome, adjusting for potential infant- and parent-related confounding factors.
Results:
Among full-term children, SGA children were more likely to interrupt people (OR 1.10, 95% CI 1.01, 1.20), unable to wait his/her turn (OR 1.17, 95% CI 1.00, 1.38), and destroy toys and/or books (OR 1.15, 95% CI 1.00, 1.31).
Conclusions:
This is the largest study ever conducted on this issue. SGA birth is negatively associated with some attentional problems and aggressive behavior at school age among full-term children. Appropriate long-term developmental follow-up and support may be needed for full-term SGA infants.
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