Abstract
Children who were growth restricted in utero (FGR) and are born small for gestational age (SGA) may experience poorer long term neurological and cognitive outcomes. Those also born preterm may have particular difficulties. The objective of this paper was to review the literature on school age neurocognitive outcome for term and preterm children that was published in the last 15 years. Considering term born children first, there is evidence that these children are at higher risk for Cerebral Palsy (CP) than those born appropriate for gestational age (AGA); information on neuromotor function in the absence of CP is somewhat contradictory. With regards to cognitive outcome, the most common finding was that being born SGA and/or FGR at term does not impact negatively on general intellectual functioning, commonly assessed by IQ scores. There was some indication that they may experience particular problems with attention. With regards to children born preterm, the risk of CP appears not to be increased compared to those preterms born AGA. For preterm children who do not develop CP, motor outcome is more affected by post-natal and post-neonatal brain growth than intrauterine growth. In contrast to term born children, preterm SGA and/or FGR children are at increased risk of cognitive and behavioral difficulties, and in common with term born children, are at higher risk than their AGA counterparts of difficulties with attentional control. In conclusion, preterm born SGA and/or FGR children are at higher risk of neurodevelopmental problems in the school years. It is important to continue to follow up children into the school age years because these difficulties may take time to emerge, and may be more visible in the more demanding school environment.
Highlights
Children who were growth restricted in utero (FGR) and are born small for gestational age (SGA) may experience poorer long term neurological and cognitive outcomes
SGR associated with impaired cognitive and school performance Outcome of asymmetric growth restriction (AGR) differed according to Head Circumference (HC): head growth restriction (HGR) associated with impaired cognitive function; weight growth restriction (WGR) not associated with cognitive outcome No higher risk for Cerebral Palsy (CP) in SGR
Who do not develop CP, which is supported by Neubauer et al (68), who examined 448 children born
Summary
Children who were growth restricted in utero (FGR) and are born small for gestational age (SGA) may experience poorer long term neurological and cognitive outcomes. Those born preterm may have particular difficulties. Pdf) in the UK, and the American College of Obstetricians and Gynecologists, refers to a newborn with a weight or abdominal circumference at birth at less than the 10th centile, either according to population based growth charts or centiles that take into account factors such as gestational age, sex, ethnicity, and maternal characteristics This can be divided into normal (i.e., constitutionally small), non-placenta mediated growth restriction (for example, chromosomal abnormalities, syndromes, infections), and placental mediated growth restriction. Preterm birth per se poses a risk for long term neurological and developmental impairment and the combination with FGR is likely to add to this risk, it may be difficult to disentangle the effects of FGR from the effect of prematurity, and, there have been somewhat inconsistent and contradictory finding in existing studies
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