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Updated: Dec 20, 2025

Examining Recall Memory in Infancy and Early Childhood Using the Elicited Imitation Paradigm
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Small for gestational age-cognitive performance from infancy to adulthood: an observational study.

R Eves1, M Mendonça1, P Bartmann2

  • 1Department of Psychology, Lifespan Health and Wellbeing Group, University of Warwick, Coventry, UK.

BJOG : an International Journal of Obstetrics and Gynaecology
|June 2, 2020
PubMed
Summary

Infants born small for gestational age (SGA) experience lower cognitive performance, with an 8-point IQ deficit persisting into adulthood. This effect is independent of other factors like preterm birth or socioeconomic status.

Keywords:
CognitionIQcognitive developmentgrowth restrictionsmall for gestational agetermvery preterm

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Area of Science:

  • Developmental psychology
  • Pediatric neurology
  • Public health

Background:

  • Small for gestational age (SGA) is a significant concern in perinatal health.
  • Cognitive development trajectories in SGA individuals require further elucidation.
  • The influence of confounding factors like very preterm/very low birthweight (VP/VLBW), socioeconomic status (SES), and parent-infant relationship on SGA outcomes is not fully understood.

Purpose of the Study:

  • To investigate the long-term effects of being born small for gestational age (SGA) on cognitive performance from infancy to adulthood.
  • To determine if the choice of SGA reference standard impacts these findings.
  • To assess the independent contributions of SGA, VP/VLBW, SES, and parent-infant relationship to cognitive outcomes.

Main Methods:

  • Longitudinal study of 414 participants from the Bavarian Longitudinal Study.
  • SGA classification using neonatal or fetal growth references.
  • Cognitive performance assessed via developmental quotient (DQ) and intelligence quotient (IQ) tests at multiple time points from infancy to 26 years of age.

Main Results:

  • SGA was consistently associated with an 8-point lower IQ compared to appropriate for gestational age peers, irrespective of the reference standard used.
  • This IQ deficit associated with SGA showed minimal narrowing into adulthood.
  • Very preterm/very low birthweight (VP/VLBW), low socioeconomic status (SES), and a poor parent-infant relationship were also independently associated with significantly lower IQ scores.

Conclusions:

  • Small for gestational age (SGA) is linked to enduring lower cognitive performance throughout development.
  • The cognitive impact of SGA is independent of VP/VLBW, SES, and parent-infant relationship quality.
  • Social factors exert an influence on IQ comparable to SGA, highlighting their importance in intervention strategies.