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close this bookCauses 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)
close this folderReport of the IDECG/IUNS working group on IUGR effects on neurological, sensory, cognitive, and behavioral function
View the document(introductory text...)
View the documentLimitations of available evidence
View the documentGeneralizations
View the documentNeurologic and sensory outcomes
View the documentCognition
View the documentResearch needs
View the documentRecommendations

Limitations of available evidence

Several factors hamper the interpretation of the empirical evidence relating intrauterine growth retardation (IUGR), both in infants born at term and preterm, to neurological, sensory, cognitive and behavioral function:

- The definitions of both IUGR and putative outcomes vary.

- Study samples are heterogeneous with respect to the etiology of IUGR, and one therefore cannot tell if outcomes differ as a function of the causes that led to IUGR.

- IUGR is almost always associated with other conditions having an adverse effect on outcomes. Pregnancy and neonatal complications, especially those associated with hypoxia, as well as postnatal malnutrition and childhood illness, are frequently associated with IUGR and may further aggravate the effect of IUGR. Some mediating and modifying factors, such as socioeconomic and environmental deprivation, are likely to persist and to have a continuing effect throughout the life span.

- The majority of studies have been conducted in high income countries and in the pre-intensive-care era.

- In follow-up studies of older children the control of postnatal influences and biased sample attrition become major problems.