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Small-for-dates babies at the age of four years: health, handicap and developmental status

M K Ounsted, V A Moar, A Scott

    Early Human Development
    |October 1, 1983
    PubMed

    Insights

    Children born small-for-dates (SFD) showed lower developmental scores by age 4. However, when birthweight was considered, no significant developmental differences persisted between SFD and average-for-dates (AFD) children.

    Area of Science:

    • Pediatrics
    • Developmental Biology
    • Public Health

    Background:

    • Small-for-dates (SFD) infants represent a significant proportion of births, with potential long-term developmental implications.
    • Understanding developmental trajectories in SFD children compared to average-for-dates (AFD) children is crucial for early intervention and health policy.
    • Previous studies have yielded mixed results regarding the long-term outcomes of SFD children.

    Purpose of the Study:

    • To compare the developmental outcomes of small-for-dates (SFD) children with average-for-dates (AFD) children up to four years of age.
    • To identify factors influencing developmental scores in both SFD and AFD groups.
    • To determine if initial birthweight differences account for long-term developmental disparities.

    Main Methods:

    • Longitudinal study involving 221 small-for-dates (SFD) and 244 average-for-dates (AFD) children.
    • Personal examinations at birth and regular follow-ups until 4 years of age.
    • Comprehensive assessment of development across five sectors, alongside analysis of various maternal and perinatal factors.

    Main Results:

    • At 4 years, SFD children had significantly lower mean scores in five developmental sectors compared to AFD children.
    • SFD children had an excess of major congenital abnormalities, but similar rates of handicap without congenital abnormality.
    • Factors like social class, method of delivery, sex, gestational age, and smoking influenced development within groups, but these differences diminished when birthweight was accounted for overall.

    Conclusions:

    • While SFD children exhibit developmental delays by age 4, these differences are largely explained by birthweight when all children are analyzed together.
    • Congenital abnormalities are more prevalent in SFD infants, but do not solely account for developmental handicaps.
    • Socioeconomic status, delivery method, sex, gestational age, and smoking are significant factors influencing child development, particularly in the AFD group.

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