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Fetal Growth Trajectories Among Small for Gestational Age Babies and Child Neurodevelopment

Kelly K Ferguson1, Sara Sammallahti2,3, Emma Rosen1

  • 1From the Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina.

Epidemiology (Cambridge, Mass.)
|June 4, 2021
PubMed

Insights

Babies born small for gestational age (SGA) who were consistently small from mid-pregnancy showed worse neurodevelopmental outcomes, including lower IQ and more ADHD symptoms. Fetal growth patterns can help identify at-risk SGA infants.

Area of Science:

  • Pediatric Neurology
  • Developmental Pediatrics
  • Prenatal Medicine

Background:

  • Being born small for gestational age (SGA) is linked to adverse neurodevelopmental outcomes.
  • However, SGA encompasses diverse fetal growth patterns, not all leading to poor outcomes.
  • Identifying specific fetal growth trajectories is crucial for predicting neurodevelopmental risks in SGA infants.

Purpose of the Study:

  • To investigate whether fetal growth trajectories can differentiate neurodevelopmental outcomes in children born small for gestational age (SGA).
  • To compare cognitive and behavioral outcomes at age 6 between SGA infants with different fetal growth patterns and non-SGA infants.

Main Methods:

  • Utilized group-based trajectory modeling on ultrasound data from mid-pregnancy and late pregnancy, plus birth weight, for SGA infants (n=656) in the Generation R cohort (N=5,487).
  • Compared nonverbal intelligence quotient (IQ) and ADHD symptoms at age 6 between SGA subgroups and non-SGA controls.

Main Results:

  • Identified three distinct fetal weight growth trajectories among SGA infants.
  • Infants consistently small from mid-pregnancy (n=64) exhibited significantly lower IQ (7 points lower) and slightly increased ADHD symptoms compared to non-SGA peers.
  • SGA infants whose growth slowed later in pregnancy showed neurodevelopmental outcomes similar to non-SGA infants.

Conclusions:

  • Fetal growth trajectories are important for understanding neurodevelopmental outcomes in SGA children.
  • Consistently small fetal growth from mid-pregnancy is associated with the poorest neurodevelopmental outcomes at age 6.
  • Fetal growth trajectory analysis can aid in identifying SGA infants at higher risk for adverse neurodevelopmental trajectories.
Abstract

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