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Small for gestational age, term babies, in the first six years of life
1Centre for International Child Health, Institute of Child Health, London.
Insights
Small for gestational age (SGA) babies may show cognitive and behavioral differences later in childhood. Early environmental factors significantly impact low birth weight (LBW) outcomes.
Area of Science:
- Developmental psychology
- Pediatric neurology
- Perinatal medicine
Background:
- Cognitive development and behavior in term-born small for gestational age (SGA) infants are reviewed.
- Challenges in comparing studies due to sample selection and confounding factors (socio-economic, perinatal, follow-up bias).
Purpose of the Study:
- To review cognitive development and behavior in term-born small for gestational age (SGA) babies during the first six years of life.
- To highlight the importance of considering interactions between covariates, such as socio-economic background and infant stimulation, in low birth weight (LBW) studies.
Main Methods:
- Review of existing studies on SGA infants and children.
- Analysis of factors influencing cognitive outcomes, including socio-economic background, parental literacy, and infant stimulation.
- Examination of developmental trajectories from infancy through early school age.
Main Results:
- Infants (<12 months) generally show no differences between SGA and normal birth weight (NBW) babies.
- Deficits in SGA children begin to appear in the second year of life, primarily in high-risk subgroups.
- At 3 years, SGA children consistently scored lower than NBW controls; differences diminished but remained significant in some studies up to age 7.
Conclusions:
- Environmental factors play a crucial role in the developmental outcomes of low birth weight (LBW) babies.
- Cognitive and behavioral deficits in small for gestational age (SGA) children may emerge later in development.
- Future research should focus on interactions between covariates and control for confounding factors more rigorously.
Abstract:
The cognitive development and behaviour in the first six years of life of small for gestational age (SGA) babies born at term are reviewed. Differences in sample selection and confounding factors associated with socio-economic background, perinatal complications and biased follow-up make the interpretation of results and the comparison of studies difficult. Studies of infants (< 12 months) generally do not show any differences between SGA babies and controls. One study, carried out in Brazil and including comprehensive data on socio-economic background, parental literacy and infant stimulation, showed that low birth weight (LBW) babies were more vulnerable to effects of the environment than normal birth weight (NBW) babies, thus illustrating the importance of looking for interactions between covariates, rather than controlling for them. Deficits begin to appear in the second year of life, but are mainly found in high-risk subgroups. In all three studies of SGA children tested at 3 years of age, the SGA children had lower scores than NBW controls. SGA children tested between 4 and 7 years had generally lower scores than NBW, but differences were smaller and sometimes did no longer reach statistically significant levels. Some recommendations are made for future studies.