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Published on: November 20, 2015
Clinical Features of Neurodevelopmental Outcomes in Children with Preterm Severe Fetal Growth Restriction: A
Takahiro Motoki1, Yoshitsugu Chigusa1, Seiichi Tomotaki2
1Department of Gynecology and Obstetrics, Kyoto University, Kyoto, Japan.
Insights
Children with severe fetal growth restriction (sFGR) born preterm show lower neurodevelopmental scores, particularly in language and social skills. Early monitoring and intervention are crucial for these infants.
Area of Science:
- Neonatal Development
- Pediatric Neurology
- Perinatal Medicine
Background:
- Fetal growth restriction (FGR) impacts fetal development, leading to potential long-term health issues.
- Severe FGR (sFGR) in preterm infants poses significant risks for neurodevelopmental outcomes.
- Limited data exists on the long-term neurodevelopmental trajectory of sFGR infants in Japan.
Purpose of the Study:
- To investigate the neurodevelopmental outcomes of preterm-born children with sFGR in Japan.
- To identify clinical factors associated with neurodevelopmental impairments in this population.
Main Methods:
- Retrospective review of clinical data from 26 preterm sFGR cases and 26 preterm appropriate for gestational age (AGA) controls.
- Assessment of developmental quotient (DQ) using the Kyoto Scale of Psychological Development at 1 and 2 years corrected age.
Main Results:
- Preterm sFGR infants exhibited significantly lower overall DQ scores compared to AGA controls (80 vs. 90.5).
- The sFGR group showed significantly impaired scores specifically in the Language-Social domain (72.5 vs. 88).
- Fetal body weight and its Z-score at birth correlated significantly with DQ scores, unlike duration of growth arrest or gestational age at birth.
Conclusions:
- Preterm infants with sFGR demonstrate greater neurodevelopmental deficits, particularly in language and social skills.
- Continuous long-term follow-up and targeted interventions are essential for preterm sFGR children.
- Birth weight and its deviation from norms are key indicators for neurodevelopmental outcomes in sFGR.
Introduction:
Fetal growth restriction (FGR) is a clinical condition wherein a fetus fails to achieve the expected growth potential. Although FGR is the leading cause of perinatal morbidity and mortality, there is a lack of knowledge about the long-term developmental outcomes of children who had FGR in Japan. Here, we sought to clarify the features of neurodevelopmental outcomes in preterm-born children with severe FGR (sFGR) and identify associated clinical factors.
Methods:
The clinical data of 26 preterm sFGR cases and 26 preterm appropriate for gestational age (AGA) cases with a similar gestational age distribution were reviewed retrospectively. Developmental quotient (DQ) scores assessed during the 1- and 2-year corrected ages using the Kyoto Scale of Psychological Development were analyzed.
Results:
sFGR was diagnosed at 26 (18-34) weeks of gestation, and the gestational age at delivery was 31 (25-36) weeks. The overall DQ scores of children in the sFGR group were significantly lower than those in the AGA group (80 vs. 90.5, P = 0.0127). Of the three areas that comprise the DQ (Postural-Motor, Cognitive-Adaptive, and Language-Social), the sFGR group only showed significantly lower DQ scores (72.5 vs. 88, P = 0.0255) in the Language-Social area. Both fetal body weight and fetal body weight Z score at birth significantly correlated with the DQ scores (r = 0.4912, P = 0.0108, and r = 0.5621, P = 0.0028), whereas neither the duration of fetal growth arrest nor the gestational age at birth correlated with the DQ scores (r = 0.3598, P = 0.0842, and r = 0.3522, P = 0.0776).
Conclusions:
Our results indicate that preterm-born children with sFGR have greater neurodevelopmental impairment than preterm-born children without FGR, specifically in terms of the DQ scores for the Language-Social area. It is imperative to encourage continuous long-term follow-up and appropriate interventions after birth.
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