The preterm small-for-gestational age infant: a two-year follow-up study

Area of Science:

• Neonatal neurology
• Developmental pediatrics
• Perinatal medicine

Background:

• Small-for-gestational age (SGA) infants born preterm (<30 weeks gestation) or at term have historically shown poor neurologic and developmental outcomes.
• Obstetric decisions for SGA fetuses often occur between 30 and 38 weeks gestation, making the outcomes of these survivors clinically relevant.

Purpose of the Study:

• To evaluate the neurologic and developmental outcomes of preterm small-for-gestational age (SGA) infants weighing less than 1,500 grams during the first two years of life.
• To compare the growth and neurodevelopmental trajectories of SGA infants with those of appropriate-for-gestation (AGA) infants.

Main Methods:

• A cohort of 28 surviving preterm SGA infants (birth weight <1,500g) were followed for two years.
• SGA infants were pair-matched with appropriate-for-gestation (AGA) infants based on birth weight.
• Evaluations included physical growth measurements (weight, length, head circumference), quarterly neurologic examinations, and quarterly Bayley Scales of Infant Development scores.

Main Results:

• SGA infants' weight, length, and head circumference reached the tenth percentile by 6-8 months, comparable to AGA infants.
• Neurologic examinations revealed similar findings between SGA and AGA groups during the first year.
• While SGA infants had lower Bayley scores initially, both groups showed similar scores by 24 months; two SGA infants had diplegia, and one AGA infant had hemiplegia at 2 years.

Conclusions:

• Preterm small-for-gestational age (SGA) infants weighing less than 1,500 grams demonstrate favorable neurologic and developmental outcomes.
• These findings provide valuable information for clinical management of mothers with suspected intrauterine growth restriction, particularly regarding delivery timing.