Document Detail


Neurodevelopmental outcome of full-term, small-for-gestational-age infants with normal placental function.
MedLine Citation:
PMID:  23303527     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the 2-year neurodevelopmental outcome of full-term, small-for-gestational-age (SGA) newborns with normal placental function, according to current criteria based on umbilical artery Doppler. PATIENTS AND METHODS: A cohort of consecutive full-term, SGA newborns with normal prenatal umbilical artery Doppler was compared with a group of full-term, appropriate-for-gestational-age (AGA) infants sampled from our general neonatal population. Neurodevelopmental outcome was evaluated at 24-months corrected age with the Bayley scale for infant and toddler development, third edition (Bayley-III), which evaluates cognitive, language, motor, social-emotional, and adaptive competencies. The effect of the study group on each domain was adjusted with multiple analysis of covariance and logistic regression for gestational age at delivery, socio-economic status, gender, tobacco smoking, and breastfeeding. RESULTS: A total of 223 infants (111 SGA and 112 AGA) were included. The groups differed significantly on socio-economic status and gestational age at delivery. All studied neurodevelopmental domains were poorer in the SGA group, reaching significance for the cognitive (100.2 vs. 92.9, adjusted p=0.027), language (101 vs. 94.7, adjusted p=0.025), motor (100 vs. 94.2, adjusted p=0.027), and adaptive (96.5 vs. 89.2, adjusted p=0.012) scores. Likewise, the SGA group had a higher risk of low scores in language (odds ratio [OR] 2.63 adjusted p=0.045) and adaptive (OR 2.72 adjusted p=0.009) domains. CONCLUSIONS: Compared to normal sized babies, full-term SGA infants, without currently used criteria defining placental insufficiency, have lower 2-year neurodevelopmental scores. These data challenge the concept that SGA fetuses with normal umbilical artery Doppler are "constitutionally small" and otherwise completely normal.
Authors:
Stefan Savchev; Magda Sanz-Cortes; Cruz-Martinez Rogelio; Angela Arranz; Botet Francesc; Gratacos Eduard; Figueras Francesc
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-10
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:  Ultrasound Obstet Gynecol     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-10     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 © 2013 ISUOG. Published by John Wiley & Sons, Ltd.
Affiliation:
Perinatal Research Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
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