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Being Small for Gestational Age: Does it Matter for the Neurodevelopment of Premature Infants? A Cohort Study

BACKGROUND: Whether being small for gestational age (SGA) increases the risk of adverse neurodevelopmental outcome in premature infants remains controversial. OBJECTIVE: to study the impact of SGA (birthweight < percentile 10) on cognition, behavior, neurodevelopmental impairment and use of thera...

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Autores principales: Bickle Graz, Myriam, Tolsa, Jean-François, Fischer Fumeaux, Céline Julie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4428889/
https://www.ncbi.nlm.nih.gov/pubmed/25965063
http://dx.doi.org/10.1371/journal.pone.0125769
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author Bickle Graz, Myriam
Tolsa, Jean-François
Fischer Fumeaux, Céline Julie
author_facet Bickle Graz, Myriam
Tolsa, Jean-François
Fischer Fumeaux, Céline Julie
author_sort Bickle Graz, Myriam
collection PubMed
description BACKGROUND: Whether being small for gestational age (SGA) increases the risk of adverse neurodevelopmental outcome in premature infants remains controversial. OBJECTIVE: to study the impact of SGA (birthweight < percentile 10) on cognition, behavior, neurodevelopmental impairment and use of therapy at 5 years old. METHODS: This population-based prospective cohort included infants born before 32 weeks of gestation. Cognition was evaluated with the K-ABC, and behavior with the Strengths and Difficulties Questionnaire (SDQ). Primary outcomes were cognitive and behavioral scores, as well as neurodevelopmental impairment (cognitive score < 2SD, hearing loss, blindness, or cerebral palsy). The need of therapy, an indirect indicator of neurodevelopmental impairment, was a secondary outcome. Linear and logistic regression models were used to analyze the association of SGA with neurodevelopment. RESULTS: 342/515 (76%) premature infants were assessed. SGA was significantly associated with hyperactivity scores of the SDQ (coefficient 0.81, p < 0.04), but not with cognitive scores, neurodevelopmental impairment or the need of therapy. Gestational age, socio-economic status, and major brain lesions were associated with cognitive outcome in the univariate and multivariate model, whereas asphyxia, sepsis and bronchopulmonary dysplasia were associated in the univariate model only. Severe impairment was associated with fetal tobacco exposition, asphyxia, gestational age and major brain lesions. Different neonatal factors were associated with the use of single or multiple therapies: children with one therapy were more likely to have suffered birth asphyxia or necrotizing enterocolitis, whereas the need for several therapies was predicted by major brain lesions. DISCUSSION: In this large cohort of premature infants, assessed at 5 years old with a complete panel of tests, SGA was associated with hyperactive behavior, but not with cognition, neurodevelopmental impairment or use of therapy. Birthweight <10th percentile alone does not appear to be an independent risk factor of neurodevelopmental adverse outcome in preterm children.
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spelling pubmed-44288892015-05-21 Being Small for Gestational Age: Does it Matter for the Neurodevelopment of Premature Infants? A Cohort Study Bickle Graz, Myriam Tolsa, Jean-François Fischer Fumeaux, Céline Julie PLoS One Research Article BACKGROUND: Whether being small for gestational age (SGA) increases the risk of adverse neurodevelopmental outcome in premature infants remains controversial. OBJECTIVE: to study the impact of SGA (birthweight < percentile 10) on cognition, behavior, neurodevelopmental impairment and use of therapy at 5 years old. METHODS: This population-based prospective cohort included infants born before 32 weeks of gestation. Cognition was evaluated with the K-ABC, and behavior with the Strengths and Difficulties Questionnaire (SDQ). Primary outcomes were cognitive and behavioral scores, as well as neurodevelopmental impairment (cognitive score < 2SD, hearing loss, blindness, or cerebral palsy). The need of therapy, an indirect indicator of neurodevelopmental impairment, was a secondary outcome. Linear and logistic regression models were used to analyze the association of SGA with neurodevelopment. RESULTS: 342/515 (76%) premature infants were assessed. SGA was significantly associated with hyperactivity scores of the SDQ (coefficient 0.81, p < 0.04), but not with cognitive scores, neurodevelopmental impairment or the need of therapy. Gestational age, socio-economic status, and major brain lesions were associated with cognitive outcome in the univariate and multivariate model, whereas asphyxia, sepsis and bronchopulmonary dysplasia were associated in the univariate model only. Severe impairment was associated with fetal tobacco exposition, asphyxia, gestational age and major brain lesions. Different neonatal factors were associated with the use of single or multiple therapies: children with one therapy were more likely to have suffered birth asphyxia or necrotizing enterocolitis, whereas the need for several therapies was predicted by major brain lesions. DISCUSSION: In this large cohort of premature infants, assessed at 5 years old with a complete panel of tests, SGA was associated with hyperactive behavior, but not with cognition, neurodevelopmental impairment or use of therapy. Birthweight <10th percentile alone does not appear to be an independent risk factor of neurodevelopmental adverse outcome in preterm children. Public Library of Science 2015-05-12 /pmc/articles/PMC4428889/ /pubmed/25965063 http://dx.doi.org/10.1371/journal.pone.0125769 Text en © 2015 Bickle Graz et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Bickle Graz, Myriam
Tolsa, Jean-François
Fischer Fumeaux, Céline Julie
Being Small for Gestational Age: Does it Matter for the Neurodevelopment of Premature Infants? A Cohort Study
title Being Small for Gestational Age: Does it Matter for the Neurodevelopment of Premature Infants? A Cohort Study
title_full Being Small for Gestational Age: Does it Matter for the Neurodevelopment of Premature Infants? A Cohort Study
title_fullStr Being Small for Gestational Age: Does it Matter for the Neurodevelopment of Premature Infants? A Cohort Study
title_full_unstemmed Being Small for Gestational Age: Does it Matter for the Neurodevelopment of Premature Infants? A Cohort Study
title_short Being Small for Gestational Age: Does it Matter for the Neurodevelopment of Premature Infants? A Cohort Study
title_sort being small for gestational age: does it matter for the neurodevelopment of premature infants? a cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4428889/
https://www.ncbi.nlm.nih.gov/pubmed/25965063
http://dx.doi.org/10.1371/journal.pone.0125769
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