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Neurodevelopment Outcome in Children with Fetal Growth Restriction at Six Years of Age: A Retrospective Cohort Study
María José Benítez Marín1,2, Juan Antonio Blanco Elena1,3, Jesús Marín Clavijo4
1Medicine School, Malaga University, 29071 Málaga, Spain.
Insights
Neurodevelopmental delays are common in children with fetal growth restriction (FGR), affecting over half of those studied. Higher gestational age at delivery and improved fetal circulation indicators predict better outcomes for these children.
Area of Science:
- Pediatrics
- Neuroscience
- Developmental Biology
Background:
- Fetal growth restriction (FGR) impacts neurodevelopmental outcomes.
- Early identification of risk factors is crucial for timely intervention.
Purpose of the Study:
- To describe neurodevelopment in children with FGR at age six.
- To identify factors influencing neurodevelopment and predict at-risk populations for early support.
Main Methods:
- A cohort of 70 children with FGR was assessed at age six using the Batelle Development Inventory.
- FGR was defined by birth weight percentiles and Doppler studies.
- Pregnancy, delivery, postpartum, neonatal care, and sociodemographic data were collected.
Main Results:
- A 57.1% rate of global developmental delay was observed in children with FGR.
- Cognitive delays affected 17.1%, with motor and communication skills most impacted.
- Higher gestational age at delivery, socioeconomic status, and middle cerebral artery pulsatility index correlated with better global development.
Conclusions:
- Children with FGR exhibit a high prevalence of neurodevelopmental delays.
- Gestational age at delivery and fetal hemodynamic measures are significant predictors of neurodevelopmental outcomes in FGR.
Objective:
This study aimed to describe neurodevelopment in fetal growth restriction children at the age of six. Secondly, we tried to demonstrate influencing factors that can improve or exacerbate this development, as well as predictive factors that might select a population at risk to assist with early childhood support.
Method:
It was a study of 70 children affected with FGR. FGR was based on these definitions: birth weight below the 3rd percentile or birth weight below the 10th percentile with an abnormal hemodynamic Doppler study. Neurodevelopment was assessed at 6 years old by means of Batelle Development Inventory. A global development quotient under a 100 score was considered a neurodevelopment delay. All variables regarding pregnancy care, delivery episode, postpartum, neonatal care, sociodemographic issues, and the need for support in the first years were studied.
Results:
The mean gestational age at diagnosis was 33.14 weeks (standard deviation (SD = 4.31), with 32.9% of early-onset diagnoses. The mean gestational age at delivery was 35.61 (SD = 3.21), and the cesarean rate was 64.3%. The average age of the children at the moment of the evaluation was 76.20-month-old (SD = 3.70). The mean global development quotient was 97.28 (SD = 13.97). We were able to record a 57.1% of global development delay. In the cases of cognition, only 17.1% of the children registered a delay. Motor and communication skills were the most frequently affected. We discovered that socioeconomic status was positively related to the global development quotient, as well as both gestational age at delivery and middle cerebral artery pulsatility index was positively related to the global development quotient.
Conclusions:
We found a higher neurodevelopment delay rate (57.1%). We could relate a higher gestational age at delivery and a higher MCA percentile with better global neurodevelopment quotients.
