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Growth and development of full-term nonasphyxiated small-for-gestational-age newborns: follow-up through adolescence
Insights
Small-for-gestational-age (SGA) infants born full-term without asphyxia show permanent physical growth deficits. However, these children demonstrate normal neurologic and cognitive development, suggesting a good prognosis.
Area of Science:
- Pediatric Growth and Development
- Neonatal Studies
- Human Development Research
Background:
- Previous small-for-gestational-age (SGA) infant studies lacked controls for socioeconomic status and parental height.
- Distinguishing SGA effects from prematurity, asphyxia, and intrauterine growth retardation (IUGR) was challenging.
Purpose of the Study:
- To assess long-term physical growth and neurodevelopment in full-term, nonasphyxiated SGA infants.
- To overcome methodologic limitations in prior SGA research.
Main Methods:
- Follow-up study of 33 full-term, nonasphyxiated SGA neonates and 33 matched normal birth weight controls.
- Comparison of physical growth, sexual development, neurologic, and cognitive function at ages 13-19 years.
Main Results:
- SGA cohort exhibited significant deficits in height, weight, and head circumference, even after adjustments.
- Sexual development and bone age were not delayed, indicating permanent growth impairment.
- SGA group showed trends toward lower neurologic and cognitive scores, but remained within normal ranges.
Conclusions:
- Full-term, nonasphyxiated SGA infants have impaired physical growth potential but a favorable prognosis for neurodevelopment.
- Observed cognitive deficits in prior studies may stem from confounding effects of asphyxia, not isolated IUGR.
Abstract:
Previous studies of growth and development in small-for-gestational-age (SGA) infants have been plagued by several methodologic defects, including a lack of control for socioeconomic status and parental height and an inability to distinguish among the effects of prematurity, neonatal asphyxia, and intrauterine growth retardation. An attempt has been made to overcome these defects in a study of 33 full-term, nonasphyxiated small-for-gestational-age neonates born between 1960 and 1966 and 33 matched control infants of normal birth weight. The infants were followed up and compared for physical growth and sexual, neurologic, and cognitive development at ages 13 to 19 years. Significant deficits in height, weight, and head circumference were found among the SGA cohort, even after statistical adjustment for differences in socioeconomic status and parental height. Sexual development and bone age were not delayed in the SGA group, however, indicating that the deficits in growth are permanent. On neurologic and cognitive testing, the SGA group had trends toward lower scores but scores were well within the normal range. It is concluded that full-term nonasphyxiated SGA infants have an impaired potential for physical growth, but a good prognosis for neurologic and cognitive development. Previous findings of more severe cognitive deficits are attributed to a failure to distinguish the effects of isolated intrauterine growth retardation from effects due to asphyxia.