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Updated: Oct 21, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
19:15

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

Thin-for-gestational age infants are at increased risk of neurodevelopmental delay at 2 years

Sinéad M O'Neill1, Geraldine Hannon2, Ali S Khashan1,3

  • 1Irish Centre for Fetal and Neonatal Translational Research, Cork University Maternity Hospital, University College Cork, Cork, Ireland.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|April 21, 2017
PubMed

Insights

Infants with low birth weight or low body fat percentage are at higher risk for developmental delays. Thin-for-gestational age (TGA) infants, especially those who are also small-for-gestational age (STGA), showed poorer cognitive outcomes at two years.

Area of Science:

  • Neonatal development
  • Pediatric health
  • Developmental pediatrics

Background:

  • Infants born small-for-gestational age (SGA) face increased risks of developmental difficulties, making early identification crucial.
  • Neonatal body composition and customized birthweight centiles are key factors influencing infant development.
  • This study investigates the impact of these factors on neurocognitive and behavioral outcomes at age two.

Purpose of the Study:

  • To determine the effect of neonatal body composition and customized birthweight centiles on neurocognitive and behavioral outcomes at age two.
  • To identify specific risk factors for developmental delay in infants.
  • To compare outcomes between SGA, thin-for-gestational age (TGA), small- and thin-for-gestational age (STGA), and appropriate-for-gestational age (AGA) infants.

Main Methods:

  • A prospective cohort study involving term infants from the Cork BASELINE Birth Cohort Study.
  • Infants were categorized into SGA (<10th customized birthweight centile), TGA (<10th body fat percentage centile), STGA (both SGA and TGA), and AGA (reference) groups.
  • Neurocognitive and behavioral outcomes were assessed at 24 months using the Bayley Scales of Infant Development III and the Child Behaviour Checklist.

Main Results:

  • Infants born thin-for-gestational age (TGA) exhibited significantly lower scores in language, cognitive, and motor domains compared to AGA infants.
  • Small- and thin-for-gestational age (STGA) infants showed poorer cognitive outcomes, with a higher adjusted odds ratio for developmental delay at two years.
  • Outcomes for SGA infants did not significantly differ from the AGA reference group.

Conclusions:

  • Thin-for-gestational age (TGA) infants, particularly those also born small-for-gestational age (STGA), face an elevated risk of developmental delay at two years.
  • Neonatal body composition is a critical predictor of developmental outcomes.
  • Early identification of TGA and STGA infants is essential for timely intervention and support.
Abstract

Keywords:
devfetgrn

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