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Association between small-for-gestational age and neurocognitive impairment at two years of corrected age among infants born at preterm gestational ages: a cohort study.

CPQCC Publication
TitleAssociation between small-for-gestational age and neurocognitive impairment at two years of corrected age among infants born at preterm gestational ages: a cohort study.
Publication TypeJournal Article
Year of Publication2017
AuthorsGirsen AI, Do SC, El-Sayed YY, Hintz SR, Blumenfeld YJ
JournalJ Perinatol
Volume37
Issue8
Pagination958-962
Date Published2017 08
ISSN1476-5543
KeywordsBirth Weight, Child, Preschool, Cohort Studies, Female, Gestational Age, Humans, Infant, Newborn, Infant, Premature, Infant, Small for Gestational Age, Mental Status and Dementia Tests, Neurocognitive Disorders, Severity of Illness Index, Statistics as Topic, United States
Abstract

OBJECTIVE: To investigate the association between small-for-gestational age (SGA) and neurocognitive impairment at 2 years of corrected age among infants born at preterm gestational ages.

STUDY DESIGN: A secondary analysis of a prospectively conducted NICHD/Maternal-Fetal Medicine Units BEAM trial. Non-anomalous pregnancies delivered before 37 weeks of gestation were included in the analysis. Neurocognitive outcomes at 2 years of corrected age were compared between infants who were SGA (<10% for gestational age) and those appropriately grown (AGA). The primary outcome was a severe or moderate neurocognitive impairment at 2 years of corrected age among survivors, defined as either mental (MDI) or psychomotor (PDI) developmental index score <70 for severe and <85 for moderate impairment.

RESULTS: Of 2299 preterm neonates 67 (3%) were SGA. SGA infants were more often twin pregnancies (31% vs 17%, P=0.003) and delivered more often by cesarean section (63% vs 40%, P<0.001) at similar gestational ages (30.0±2.6 vs 29.5±2.8 weeks, P=0.11). At 2 years of corrected age, SGA and AGA survivors had similar rates of neurocognitive impairment (MDI <70: 18% vs 18%, P=1.0; MDI <85: 44% vs 46%, P=0.96; PDI <70: 20% vs 15%, P=0.51; PDI <85: 40% vs 34%, P=0.48).

CONCLUSION: In this cohort, SGA at preterm gestational ages was associated with similar rates of neurocognitive impairment at two years of corrected age among surviving infants.

DOI10.1038/jp.2017.58
Alternate JournalJ Perinatol
PubMed ID28448062
PubMed Central IDPMC5800317
Grant ListUG1 HD068268 / HD / NICHD NIH HHS / United States