Background: Neurocognitive retardation is one of the most important consequences that small for gestational age (SGA) children may suffer although conflicting results have been published.
Objective and hypotheses: The aim of this study was to study psychomotor development (PD) in children born SGA during the first two years of life in order to identify children at risk as early as possible.
Method: 108 cases borh SGA have been studied between 3 months and 2 years of age. Girls: n=59 (54.6%). 76 were born at term (six twins) and 32 were preterm (<37 weeks). Catch up growth occurred in 65.3% of term and in 67.9% of preterm children. Mean gestational age was 37.5 weeks. Length was −2.7±0.5 SDS, weight was −2.45±0.8 SDS, and head circumference was −2.1±1.1 SDS. SGA children suffering perinatal comorbidity with a known negative impact on PD were excluded in order to avoid confounding factors. PD was evaluated by the Brunet Lezine test in a cross-sectional and longitudinal study. Results were compared with normal controls and expressed in SDS. Patients and controls have been evaluated by the same psychologist.
Results: Cross-sectional study. Mean developmental quotient (DQ) was −1.1±1.2 SDS at a mean age of 10.4±7.7 months of age (n=108). DQ at different time points were as follows −1.4±1.4 SDS at 3 months; −0.9±1.1 SDS at 6 months; −1.1±1.1 SDS at 9 months; −1.1±1.1 SDS at 12 months; −1.0±0.7 SDS at 18 months; and −1.0±1.2 SDS at 24 months. When comparing with controls there were significant differences at 3, 6, 12, and 24 months of age. Mean DQ in SGA term children was −1.1±1.2 SDS at a mean age of 9.8±8 months and in preterm children was −1.3±1.1 SDS at a mean age of 11.8±7 months without showing significant difference between both groups. Longitudinal study. 30 SGA children had been followed longitudinally showing the following results: −1.3±1.2 SDS at 4.2±1.9 months; −0.7±1.1 SDS at 7.3±2.0 months; −0.9±1.2 SDS at 10.6±2.8 months; and −0.8±1.2 SDS at 14.6±4.1 months.
Conclusion: A negative impact on psychomotor development in children born SGA has been observed early after birth. During infancy psychomotor DQ is around 1 SDS with 23% of children showing values ≤2 SDS at 10 months of age. Considering that confounding factors had been eliminated, SGA can be considered a condition that have an early negative impact on neurocognitive development and preventive measures should be taken.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology