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Subtle impairment of neurodevelopment in infants with late fetal growth restriction

Laura Lucaccioni1, Alessandra Boncompagni1, Marisa Pugliese2

  • 1Neonatal Intensive Care Unit, Department of Clinical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|January 18, 2021
PubMed

Insights

Late fetal growth restriction (FGR) infants show fewer fidgety movements and developmental differences by age two, even after growth recovery. Early cranial circumference predicts fidgety movements in these high-risk newborns.

Area of Science:

  • Neonatalogy
  • Developmental Pediatrics
  • Neuroscience

Background:

  • Late fetal growth restriction (FGR) increases the risk of being born small for gestational age (SGA), leading to potential neurodevelopmental impairments.
  • General movements assessment, particularly at the fidgety age, is a key predictor of neurological dysfunction in infants.

Purpose of the Study:

  • To assess growth recovery, fidgety movements at 3 months, and neurodevelopmental outcomes at 2 years in term infants with late FGR compared to controls.
  • To identify predictors of neurological outcomes in infants with late FGR.

Main Methods:

  • Prospective clinical evaluation of term infants with late FGR and adequate for gestational age (AGA) controls.
  • Assessment of auxological parameters and neurological examination at 3 months.
  • Neurodevelopmental outcome evaluation using Griffiths Mental Development Scales (GMDS-R) at 24 months.

Main Results:

  • Despite catch-up growth, 13% of late FGR infants had auxological parameters below the 3rd percentile at 3 months.
  • Significantly fewer late FGR infants exhibited fidgety movements (23.7%) compared to AGA controls (100%) (p < .001).
  • Cranial circumference at birth was a positive predictor for fidgety movements (p = .039), and significant differences in GMDS-R scores were observed between groups at 2 years.

Conclusions:

  • Fidgety movements were less prevalent in late FGR infants, irrespective of growth recovery.
  • Neurodevelopmental assessments at 2 years revealed differences across all domains between late FGR and AGA infants, though outcomes remained within normal ranges.
Abstract

Keywords:
General movementsadequate for gestational agefidgety movementslate fetal growth restrictionneurodevelopment Introductionsmall for gestational age

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