Document Detail


Neurodevelopmental delay in small babies at term. A systematic review.
MedLine Citation:
PMID:  22302630     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: Being small for gestational age (SGA) or having fetal growth restriction (FGR) may be associated with poorer neurodevelopmental outcomes compared to being appropriate for gestational age (AGA). The aim of this paper was to evaluate the existence and magnitude of decrease in neurodevelopmental scores in SGA and FGR infants born at term from a systematic review of the existing literature. Methods: Studies of neurodevelopment in SGA/FGR babies were identified from a search of the internet scientific databases. Studies which included preterm births and those that did not define absolute indices of standardised cognitive outcome were excluded. SGA was defined as birthweight below the 10(th) centile for gestation and FGR as the same birthweight standard with abnormal umbilical artery Dopplers or evidence of abnormal placentation on pathology specimen studies. Effect size was calculated as the standardised mean difference between neurodevelopment scores of controls and SGA/FGR children. Findings: There were 28 studies of SGA, with a total of 7861 SGA and 91619 control AGA babies, and 3 studies of FGR, with a total of 119 FGR and 49 control AGA babies. Data synthesis showed that standardised neurodevelopmental scores in SGA babies was 0.32 SD (95%CI = 0.25 to 0.38) below those for normally grown controls, though with heterogeneity between studies (I(2) = 68.3%). Insufficient data was available for FGR babies. Interpretation: The findings of the study demonstrate that among babies born at term gestation, being SGA is associated with lower scores on neurodevelopmental outcomes compared to AGA controls. A trial designed to evaluate effect of intervention in small fetuses born at term in order to improve the neurodevelopmental outcome is urgently needed. Funding: There was no funding for this study. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Authors:
T Arcangeli; B Thilaganathan; R Hooper; K S Khan; A Bhide
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-3
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  -     ISSN:  1469-0705     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Fetal Medicine Unit, Academic department of Obstetrics and Gynecology, St. George's University of London, United Kingdom.
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