G Gascoin1, C Flamant. 1. Service de réanimation et médecine néonatales, pôle femme-mère-enfant, CHU Angers, 4, rue Larrey, 49933 Angers cedex 9, France. Electronic address: GeGascoin@chu-angers.fr.
Abstract
OBJECTIVE: To evaluate long-term outcome after history of intra-uterine growth restriction (IUGR) and/or birth small for gestational age (SGA). METHODS: This systematic evidence review is based on Pubmed search, Cochrane library and experts recommendations. RESULTS: Neurodevelopmental evaluation at 2 years is lower in those infants, born premature or not. SGA is associated with a high risk of minor cognitive deficiencies, hyperactivity or attention deficit disorders at 5 years or scholar difficulties at 8 years. Those infants are at high risk of metabolic syndrome in adulthood. Most of them will catch up at 6 months for weight and 12 months for height. Even if IUGR is associated with high risk of bronchodysplasia, up to this day, the review of literature did not permit to evaluate respiratory outcome. Adults born SGA have good quality of live and normal professional insertion. One cohort study and more and more animal studies suggest potential trans generational effects. CONCLUSION: Infants born SGA and/or with history of IUGR are at high risk of minor cognitive deficiencies and scholar difficulties. They are also at high risk of metabolic syndrome in adulthood. However, prematurity seems to have a higher effect than IUGR and/or SGA on long-term outcomes.
OBJECTIVE: To evaluate long-term outcome after history of intra-uterine growth restriction (IUGR) and/or birth small for gestational age (SGA). METHODS: This systematic evidence review is based on Pubmed search, Cochrane library and experts recommendations. RESULTS: Neurodevelopmental evaluation at 2 years is lower in those infants, born premature or not. SGA is associated with a high risk of minor cognitive deficiencies, hyperactivity or attention deficit disorders at 5 years or scholar difficulties at 8 years. Those infants are at high risk of metabolic syndrome in adulthood. Most of them will catch up at 6 months for weight and 12 months for height. Even if IUGR is associated with high risk of bronchodysplasia, up to this day, the review of literature did not permit to evaluate respiratory outcome. Adults born SGA have good quality of live and normal professional insertion. One cohort study and more and more animal studies suggest potential trans generational effects. CONCLUSION:Infants born SGA and/or with history of IUGR are at high risk of minor cognitive deficiencies and scholar difficulties. They are also at high risk of metabolic syndrome in adulthood. However, prematurity seems to have a higher effect than IUGR and/or SGA on long-term outcomes.
Keywords:
Devenir à long terme; Intra uterine growth restriction (IUGR); Long-term outcomes; Nouveau-nés à terme; Petit pour l’âge gestationnel (PAG); Preterm infants; Prématurés; Retard de croissance intra-utérin (RCIU); Small for gestational age (SGA); Term infants