A I Girsen1, S C Do1, Y Y El-Sayed1, S R Hintz2, Y J Blumenfeld1. 1. Department of Obstetrics &Gynecology, Division of Maternal-Fetal Medicine, Stanford University, Stanford, CA, USA. 2. Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University, Stanford, CA, USA.
Abstract
OBJECTIVE: To investigate the association between small-for-gestational age (SGA) and neurocognitive impairment at 2 years of corrected age among infants born at preterm gestational ages. STUDY DESIGN: A secondary analysis of a prospectively conducted NICHD/Maternal-Fetal Medicine Units BEAM trial. Non-anomalous pregnancies delivered before 37 weeks of gestation were included in the analysis. Neurocognitive outcomes at 2 years of corrected age were compared between infants who were SGA (<10% for gestational age) and those appropriately grown (AGA). The primary outcome was a severe or moderate neurocognitive impairment at 2 years of corrected age among survivors, defined as either mental (MDI) or psychomotor (PDI) developmental index score <70 for severe and <85 for moderate impairment. RESULTS: Of 2299 preterm neonates 67 (3%) were SGA. SGA infants were more often twin pregnancies (31% vs 17%, P=0.003) and delivered more often by cesarean section (63% vs 40%, P<0.001) at similar gestational ages (30.0±2.6 vs 29.5±2.8 weeks, P=0.11). At 2 years of corrected age, SGA and AGA survivors had similar rates of neurocognitive impairment (MDI <70: 18% vs 18%, P=1.0; MDI <85: 44% vs 46%, P=0.96; PDI <70: 20% vs 15%, P=0.51; PDI <85: 40% vs 34%, P=0.48). CONCLUSION: In this cohort, SGA at preterm gestational ages was associated with similar rates of neurocognitive impairment at two years of corrected age among surviving infants.
OBJECTIVE: To investigate the association between small-for-gestational age (SGA) and neurocognitive impairment at 2 years of corrected age among infants born at preterm gestational ages. STUDY DESIGN: A secondary analysis of a prospectively conducted NICHD/Maternal-Fetal Medicine Units BEAM trial. Non-anomalous pregnancies delivered before 37 weeks of gestation were included in the analysis. Neurocognitive outcomes at 2 years of corrected age were compared between infants who were SGA (<10% for gestational age) and those appropriately grown (AGA). The primary outcome was a severe or moderate neurocognitive impairment at 2 years of corrected age among survivors, defined as either mental (MDI) or psychomotor (PDI) developmental index score <70 for severe and <85 for moderate impairment. RESULTS: Of 2299 preterm neonates 67 (3%) were SGA. SGA infants were more often twin pregnancies (31% vs 17%, P=0.003) and delivered more often by cesarean section (63% vs 40%, P<0.001) at similar gestational ages (30.0±2.6 vs 29.5±2.8 weeks, P=0.11). At 2 years of corrected age, SGA and AGA survivors had similar rates of neurocognitive impairment (MDI <70: 18% vs 18%, P=1.0; MDI <85: 44% vs 46%, P=0.96; PDI <70: 20% vs 15%, P=0.51; PDI <85: 40% vs 34%, P=0.48). CONCLUSION: In this cohort, SGA at preterm gestational ages was associated with similar rates of neurocognitive impairment at two years of corrected age among surviving infants.
Authors: Rebecca C Amaru; Melissa C Bush; Richard L Berkowitz; Robert H Lapinski; Sreedhar Gaddipati Journal: Obstet Gynecol Date: 2004-01 Impact factor: 7.661
Authors: Barbara J Stoll; Nellie I Hansen; Edward F Bell; Seetha Shankaran; Abbot R Laptook; Michele C Walsh; Ellen C Hale; Nancy S Newman; Kurt Schibler; Waldemar A Carlo; Kathleen A Kennedy; Brenda B Poindexter; Neil N Finer; Richard A Ehrenkranz; Shahnaz Duara; Pablo J Sánchez; T Michael O'Shea; Ronald N Goldberg; Krisa P Van Meurs; Roger G Faix; Dale L Phelps; Ivan D Frantz; Kristi L Watterberg; Shampa Saha; Abhik Das; Rosemary D Higgins Journal: Pediatrics Date: 2010-08-23 Impact factor: 7.124
Authors: Xiangming Qiu; Abhay Lodha; Prakesh S Shah; K Sankaran; Mary M K Seshia; Wendy Yee; Ann Jefferies; Shoo K Lee Journal: Am J Perinatol Date: 2011-11-30 Impact factor: 1.862
Authors: Lilia C De Jesus; Athina Pappas; Seetha Shankaran; Lei Li; Abhik Das; Edward F Bell; Barbara J Stoll; Abbot R Laptook; Michele C Walsh; Ellen C Hale; Nancy S Newman; Rebecca Bara; Rosemary D Higgins Journal: J Pediatr Date: 2013-02-14 Impact factor: 4.406
Authors: Dwight J Rouse; Deborah G Hirtz; Elizabeth Thom; Michael W Varner; Catherine Y Spong; Brian M Mercer; Jay D Iams; Ronald J Wapner; Yoram Sorokin; James M Alexander; Margaret Harper; John M Thorp; Susan M Ramin; Fergal D Malone; Marshall Carpenter; Menachem Miodovnik; Atef Moawad; Mary J O'Sullivan; Alan M Peaceman; Gary D V Hankins; Oded Langer; Steve N Caritis; James M Roberts Journal: N Engl J Med Date: 2008-08-28 Impact factor: 91.245
Authors: Anne C C Lee; Joanne Katz; Hannah Blencowe; Simon Cousens; Naoko Kozuki; Joshua P Vogel; Linda Adair; Abdullah H Baqui; Zulfiqar A Bhutta; Laura E Caulfield; Parul Christian; Siân E Clarke; Majid Ezzati; Wafaie Fawzi; Rogelio Gonzalez; Lieven Huybregts; Simon Kariuki; Patrick Kolsteren; John Lusingu; Tanya Marchant; Mario Merialdi; Aroonsri Mongkolchati; Luke C Mullany; James Ndirangu; Marie-Louise Newell; Jyh Kae Nien; David Osrin; Dominique Roberfroid; Heather E Rosen; Ayesha Sania; Mariangela F Silveira; James Tielsch; Anjana Vaidya; Barbara A Willey; Joy E Lawn; Robert E Black Journal: Lancet Glob Health Date: 2013-06-25 Impact factor: 26.763