Akihito Takeuchi1, Takashi Yorifuji2, Kyohei Takahashi3, Makoto Nakamura4, Misao Kageyama4, Toshihide Kubo3, Tatsuya Ogino5, Hiroyuki Doi6. 1. Department of Neonatology, Okayama Medical Center, National Hospital Organization, Okayama, Japan. Electronic address: gmd18025@s.okayama-u.ac.jp. 2. Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, Okayama, Japan. 3. Department of Pediatrics, Okayama Medical Center, National Hospital Organization, Okayama, Japan. 4. Department of Neonatology, Okayama Medical Center, National Hospital Organization, Okayama, Japan. 5. Department of Children Studies, Faculty of Children Studies, Chugokugakuen University, Okayama, Japan. 6. Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Abstract
OBJECTIVE: To investigate neurological development in small for gestational age (SGA) infants, with a focus on full-term SGA infants. METHODS: We analyzed data from a large, Japanese, nationwide, population-based longitudinal survey started in 2001. We restricted the study to participants born before 42weeks of gestation (n=46,563). Parents were asked questions about motor and language development when the children were 2.5years old, and about behavioral development at 5.5years. We analyzed the relationships between SGA status and development by logistic regression. Odds ratios (ORs) and 95% confidence intervals (95% CI) were calculated for each outcome for full-term and preterm births, adjusting for potential infant- and parent-related confounding factors. We also calculated the population-attributable fractions to estimate the public impact of SGA births. RESULTS: SGA full-term children were more likely to demonstrate developmental delays at 2.5years, e.g., being unable to walk alone (OR 3.0, 95% CI: 1.7, 5.3), compose a two-phrase sentence (OR 1.5, 95% CI: 1.2, 1.8), or use a spoon to eat (OR 1.5, 95% CI: 1.1, 1.9). SGA status also had some degree of negative impacts on behavioral problems at 5.5years among term children, e.g., being unable to listen without fidgeting (OR 1.2, 95% CI: 1.1, 1.3), or remain patient (OR 1.1, 95% CI: 1.0, 1.2). The public health impacts were comparable between full-term and preterm SGA children at 2.5years. CONCLUSION: SGA is a risk factor for developmental delay, even in full-term infants, with non-negligible public health impacts.
OBJECTIVE: To investigate neurological development in small for gestational age (SGA) infants, with a focus on full-term SGA infants. METHODS: We analyzed data from a large, Japanese, nationwide, population-based longitudinal survey started in 2001. We restricted the study to participants born before 42weeks of gestation (n=46,563). Parents were asked questions about motor and language development when the children were 2.5years old, and about behavioral development at 5.5years. We analyzed the relationships between SGA status and development by logistic regression. Odds ratios (ORs) and 95% confidence intervals (95% CI) were calculated for each outcome for full-term and preterm births, adjusting for potential infant- and parent-related confounding factors. We also calculated the population-attributable fractions to estimate the public impact of SGA births. RESULTS: SGA full-term children were more likely to demonstrate developmental delays at 2.5years, e.g., being unable to walk alone (OR 3.0, 95% CI: 1.7, 5.3), compose a two-phrase sentence (OR 1.5, 95% CI: 1.2, 1.8), or use a spoon to eat (OR 1.5, 95% CI: 1.1, 1.9). SGA status also had some degree of negative impacts on behavioral problems at 5.5years among term children, e.g., being unable to listen without fidgeting (OR 1.2, 95% CI: 1.1, 1.3), or remain patient (OR 1.1, 95% CI: 1.0, 1.2). The public health impacts were comparable between full-term and preterm SGA children at 2.5years. CONCLUSION: SGA is a risk factor for developmental delay, even in full-term infants, with non-negligible public health impacts.
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