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Associations of fetal and postnatal growth trajectories with child cognition: the GUSTO cohort study

Yi Ying Ong1,2, Nicholas Beng Hui Ng1,3, Navin Michael4

  • 1Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

International Journal of Epidemiology
|February 13, 2025
PubMed

Insights

Fetal abdominal circumference (AC) growth deceleration is linked to lower child IQ. Postnatal weight or BMI gain after this deceleration may not benefit cognition in well-nourished children.

Area of Science:

  • Pediatric Growth and Development
  • Fetal Medicine
  • Cognitive Neuroscience

Background:

  • Longitudinal ultrasounds can serve as improved fetal growth markers.
  • Investigating fetal growth markers is crucial for understanding child development.
  • Fetal growth patterns may influence long-term cognitive outcomes.

Purpose of the Study:

  • To determine if accelerated postnatal growth after fetal abdominal circumference (AC) growth deceleration is associated with improved child cognition.
  • To explore the relationship between fetal growth patterns and cognitive development.
  • To identify potential critical periods for postnatal catch-up growth impacting cognition.

Main Methods:

  • Utilized data from 797 term-born singletons in the GUSTO cohort.
  • Derived fetal AC growth z-scores and deceleration from 2nd-3rd trimester ultrasounds.
  • Assessed standardized postnatal growth (height, weight, BMI) and cognitive function (IQ) from infancy to early childhood, adjusting for confounders.

Main Results:

  • Fetal AC growth deceleration occurred in 23.3% of newborns and was linked to lower non-verbal IQ at 4.5 years.
  • Higher overall BMI gain (0-7 years) correlated with lower non-verbal IQ at 7 years.
  • Higher late infancy BMI gain showed mixed associations: higher verbal IQ at 4.5 years but lower non-verbal IQ at 7 years.
  • Among those with fetal AC growth deceleration, increased weight gain (0-7 years) was associated with lower non-verbal IQ at 7 years.
  • Children with fetal AC growth deceleration generally achieved catch-up growth in height, weight, and BMI by age 7.

Conclusions:

  • Fetal abdominal circumference (AC) growth deceleration is associated with reduced cognitive scores in early childhood.
  • Accelerated postnatal weight or BMI gain following fetal AC growth deceleration may not be beneficial for cognitive development in well-nourished children.
  • These findings highlight the complex interplay between fetal growth, postnatal development, and cognitive outcomes.
Abstract

Keywords:
body mass indexcognitiondevelopmental origins of health and diseaseearly childhoodfetal growthgrowth trajectoriesintelligenceneurodevelopmentpostnatal growthweight gain

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