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Growth and development during the first year in a cohort of low income term-born American children
K G Nelson1, R L Goldenberg, H J Hoffman
1Department of Pediatrics, University of Alabama at Birmingham, USA.
Insights
Infants born small for gestational age (SGA) showed slower growth but improved catch-up growth in length and head circumference by age one. Cognitive development was similar, with only psychomotor scores lower in SGA infants.
Area of Science:
- Pediatric Growth and Development
- Neonatal Outcomes
- Environmental Influences on Child Health
Background:
- Infants born small for gestational age (SGA) face risks for suboptimal postnatal growth and development.
- This study focuses on low-income, term-born American infants to identify determinants of outcome in the first year.
- Understanding these factors is crucial for early intervention and improving long-term health trajectories.
Purpose of the Study:
- To evaluate biologic and environmental factors influencing the growth and development of small for gestational age (SGA) infants.
- To compare the outcomes of SGA infants with their non-SGA peers during the first year of life.
- To identify potential disparities in growth and cognitive development based on race, gender, and symmetry.
Main Methods:
- A cohort of 717 singleton births from 949 pregnancies was followed for one year.
- Infants were classified as SGA or non-SGA based on birthweight below the 15th percentile for gestational age.
- Measures included infant growth, home environment, and physical and cognitive development using standardized tests.
Main Results:
- SGA infants had significantly lower maternal height, weight, and education compared to non-SGA infants.
- At one year, SGA children remained smaller in height, weight, and head circumference but exhibited accelerated growth rates in length and head circumference.
- Cognitive functioning was comparable, except for a lower Bayley Psychomotor Development Index (PDI) in SGA infants.
Conclusions:
- Despite initial deficits, SGA infants demonstrate catch-up growth in certain parameters, suggesting resilience.
- The postnatal environment in disadvantaged households may influence the long-term impact of intrauterine growth restriction.
- Further longitudinal studies are necessary to fully understand the interplay between intrauterine growth, postnatal environment, and developmental outcomes.
Background:
Infants born small for gestational age (SGA) are at risk for poor postnatal growth and development. This study evaluates biologic and environmental determinants of outcome during the first year of life in a cohort of low income term-born American infants.
Methods:
Seven hundred and seventeen of 949 (76%) singleton births to women followed from early pregnancy were studied over their first year of life and measures of growth, home environment, physical and cognitive development were obtained. Infants were categorized as SGA or non-SGA based on birthweight < 15th percentile for gestational age. SGA and non-SGA children's outcomes were analyzed by race, gender and symmetry.
Results:
SGA infants were demographically similar to non-SGA infants but significantly lower in mean maternal height, weight and education. Birthweight, crownheel length and head circumference were all significantly smaller in SGA infants. By age 1 year, the SGA children were still shorter, lighter and had smaller head circumferences than the non-SGA children though their rate of growth during the first year was significantly greater for length and head circumference. Cognitive functioning as measured by the Bayley Scales of Infant Development and the Fagan Test of Infant Intelligence did not differ significantly except for a lower Bayley Psychomotor Development Index (PDI) in SGA infants. Since most of these children live in economically disadvantaged households, any negative consequences of poor intrauterine growth may be influenced by postnatal environment and longer term follow-up will be necessary to assess this relationship.