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Association between small for gestational age and neurodevelopmental disability at 5 years in the Hokkaido study

Satoshi Suyama1, Mariko Itoh2, Naomi Tamura2

  • 1Funded Research Division of Child and Adolescent Psychiatry, Hokkaido University Hospital, Sapporo, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|August 18, 2025
PubMed

Insights

Small for gestational age (SGA) infants, including those born at term, are at higher risk for neurodevelopmental disabilities. This study found SGA status significantly associated with total difficulties score, indicating potential developmental challenges.

Area of Science:

  • Pediatric Health
  • Developmental Neuroscience
  • Public Health

Background:

  • Low birth weight is a known risk factor for developmental delays and disabilities in children.
  • Small for gestational age (SGA) is a key indicator of low birth weight, associated with increased neurodevelopmental risks.
  • The specific impact of SGA on term newborns (term-SGA) requires further investigation.

Purpose of the Study:

  • To evaluate the association between SGA and neurodevelopmental disability in children.
  • To specifically examine the effects of term-SGA on neurodevelopmental outcomes.
  • To identify risk factors contributing to neurodevelopmental challenges in SGA infants.

Main Methods:

  • Prospective birth cohort study (Hokkaido Study on Environment and Children's Health).
  • Inclusion of 4851 children assessed at age 5 years using the Strengths and Difficulties Questionnaire (SDQ).
  • Assessment of SGA and term-SGA status using the Japan Pediatric Society birth weight database.

Main Results:

  • A significant association was found between SGA/term-SGA status and the total difficulties score (TDS) in multivariate analysis.
  • Term-SGA status showed an odds ratio of 1.72 (95% CI: 1.07-2.76) for TDS.
  • SGA status showed an odds ratio of 1.75 (95% CI: 1.10-2.78) for TDS.
  • No significant association was observed between SGA/term-SGA status and hyperactivity/inattention.

Conclusions:

  • Small for gestational age (SGA) status, even in term newborns, may increase the risk of neurodevelopmental disability.
  • The findings highlight the importance of monitoring SGA infants for potential developmental challenges.
  • Further research is warranted to understand the mechanisms linking SGA to neurodevelopmental outcomes.
Abstract

Keywords:
cohort studiesinfantpreschool childsmall for gestational agestrengths and difficulties questionnaire

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