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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

Journal of Perinatology volume 37, pages 958–962 (2017)Cite this article

Subjects

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.

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Acknowledgements

We acknowledge the assistance of NICHD, the MFMU Network and the Protocol Subcommittee in making the database available on behalf of the project. The contents of this report represent the views of the authors and do not represent the views of the Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network or the National Institutes of Health.

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Authors and Affiliations

  1. Department of Obstetrics & Gynecology, Division of Maternal-Fetal Medicine, Stanford University, Stanford, CA, USA

    A I Girsen, S C Do, Y Y El-Sayed & Y J Blumenfeld

  2. Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University, Stanford, CA, USA

    S R Hintz

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  1. A I Girsen
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  2. S C Do
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  3. Y Y El-Sayed
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Correspondence to A I Girsen.

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The authors declare no conflict of interest.

Additional information

This manuscript was presented in oral format at the 36th Annual Meeting of the Society for Maternal-Fetal Medicine, Atlanta, GA, 1 to 6 February 2016.

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Girsen, A., Do, S., El-Sayed, Y. et al. 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. J Perinatol 37, 958–962 (2017). https://doi.org/10.1038/jp.2017.58

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