|Causes and Consequences of Intrauterine Growth Retardation, Proceedings of an IDECG workshop, November 1996, Baton Rouge, USA, Supplement of the European Journal of Clinical Nutrition (International Dietary Energy Consultative Group - IDECG, 1996, 100 pages)|
|Neurodevelopmental outcome of small-for-gestational-age infants|
In summary, it appears that, overall, being born SGA is associated with an increase in various measures of MND (Aylward et al, 1989; Breart and Poisson-Salomon, 1988; Allen, 1984; Teberg et al, 1988). Major motor and cognitive disability is rare in SGA infants, but is probably significantly increased when evaluated in large sample sizes. Boys seem to be more affected by being SGA than girls, and children born into the low social classes seem to be more affected than other children. If the SGA develops early so that it affects head growth before 26 weeks, there seems to be more of an impact on neurologic function than SGA which develops later (Harvey et al, 1982). Certainly SGA which is accompanied by asphyxia is more commonly associated with neurodevelopment abnormalities than SGA which is not. There does not seem to be a major relationship between SGA status and vision or hearing deficits, although there are some studies to suggest that SGA infants have more difficulty in achieving 'normal' responses to visual or auditory stimuli than do non-SGA infants.
This review suggests that SGA is a heterogeneous condition, at times but not usually associated with various types of neurodevelopment dysfunction. There are no studies we identified showing that improvements in these neurologic outcomes can be achieved by any particular course of action. Logically, however, preventing asphyxia in SGA infants should reduce the prevalence of major and minor handicaps, especially cerebral palsy and mental retardation, seen in some of these infants, particularly those who are asymmetric and associated with maternal hypertension. It is less clear if interventions directed at the more symmetric or uniformly under-grown infants will be able to improve outcome in the relatively small percentage of these children who have major developmental problems associated with being SGA.
Acknowledgement - This project is funded by the Agency for Health Care Policy Research (AHCPR) Contract #290-92-0055.