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Hypotonia at six years in prematurely-born or small-for-gestational-age children
B C Touwen1, M Hadders-Algra, H J Huisjes
1Dept. of Dev. Neurology, University of Groningen, The Netherlands.
Insights
Hypotonia without other neurological issues was found in 11% of infants with intrauterine growth retardation or preterm birth, but not in appropriate-for-gestational-age peers. This suggests subtle neurological impacts of early development challenges.
Area of Science:
- Neurology
- Developmental Pediatrics
- Neonatology
Background:
- Intrauterine growth retardation (IUGR) and preterm birth can impact infant neurodevelopment.
- Long-term neurological outcomes for these infants require further investigation.
Purpose of the Study:
- To assess neurological development at age 6 in children born small for gestational age (SGA) due to IUGR and preterm appropriate-for-gestational-age (PTAGA) infants.
- To compare findings with a reference group of full-term appropriate-for-gestational-age (FTAGA) children.
Main Methods:
- Neurological follow-up at 6 years for 143 SGA infants and 49 PTAGA infants.
- Comparison with 192 FTAGA children as a reference group.
- Assessment for hypotonia and other neurological signs.
Main Results:
- 11% of SGA and PTAGA children exhibited isolated hypotonia, absent in the FTAGA group.
- Minor neurological dysfunction was present across all groups.
- No correlation found between neurological findings and obstetrical/neonatal variables or 6-year anthropometrics.
Conclusions:
- Isolated hypotonia may be a subtle neurological consequence of IUGR or preterm birth.
- Further research is needed on placental mechanisms and early muscle development in these at-risk populations.
Abstract:
A neurological follow up study was done of 143 full-term infants who were small for gestational age based on intrauterine growth retardation and of 49 preterm appropriate-for-gestational-age (PTAGA) infants at the age of 6 years. Findings were compared with those of a reference group of 192 full-term appropriate-for-gestational-age (FTAGA) children. In 11% of the children of both study groups, hypotonia was found without any other neurological deviancy. This type of hypotonia was absent in the reference group, whereas minor neurological dysfunction consisting of hypotonia with other neurological signs was found in all the three groups of children. No relation was found with obstetrical or neonatal variables, including severity of growth retardation and gestational age, or with weight, body height or head circumference at 6 years. The possible interference of preterm birth or intrauterine growth retardation with, and the role of placental mechanisms in, fetal and early postnatal muscle development is discussed.