Associations between Preterm Birth, Small For Gestational Age, and Early Neonatal Morbidity, and Cognitive Function in School‐Age Children

Abstract

The long term consequences of preterm, small for gestational age (SGA, defined as birth weight for given gestational age less than the 10th percentile of the reference), and early newborn morbidity on functional outcomes are not well described. In rural Nepal, we assessed children (n~1900) at 7–9 y of age, for whom these exposures were available at birth. The prevalence of low birth weight (LBW), preterm, and SGA was 40%, 21%, and 55%, respectively, whereas symptoms of birth asphyxia and sepsis were reported in 7% and 9% of children. At follow‐up they were tested on aspects of intellectual, executive, and motor function. In multivariable regression analyses, low birth weight was strongly associated with scores on the Universal Nonverbal Intelligence Test (UNIT), tests of executive function, and the Movement Assessment Battery for Children (MABC). However, of the two underlying causes of LBW, preterm was not associated with any of the test scores. However, SGA was significantly associated with lower UNIT scores (−1.9 SD=0.4); higher proportion failure on the Stroop test (0.06, SD=0.02); and lower scores on the backward digit span test (−0.14, SD=0.04), MABC (0.94, SD=0.27), and finger tapping test (−0.63, SD=0.23) (all p<0.005). Neither birth asphyxia nor sepsis symptoms were significantly associated with the outcomes.Support: NICHD, Gates Foundation.