Kelly K Ferguson1, Sara Sammallahti2,3, Emma Rosen1, Michiel van den Dries2, Anjoeka Pronk4, Suzanne Spaan4, Mònica Guxens2,5,6,7, Henning Tiemeier2,3, Romy Gaillard8, Vincent W V Jaddoe8,9. 1. From the Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina. 2. Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. 3. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts. 4. Department of Risk Analysis for Products in Development, TNO, Utrecht, The Netherlands. 5. ISGlobal, Barcelona, Spain. 6. Department of Experimental and Health Sciences, Pompeu Fabra University, Barcelona, Spain. 7. Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain. 8. The Generation R Study Group, Erasmus Medical Center, Rotterdam, The Netherlands. 9. Department of Pediatrics, Erasmus Medical Center, Rotterdam, The Netherlands.
Abstract
BACKGROUND: Being born small for gestational age (SGA, <10th percentile) is a risk factor for worse neurodevelopmental outcomes. However, this group is a heterogeneous mix of healthy and growth-restricted babies, and not all will experience poor outcomes. We sought to determine whether fetal growth trajectories can distinguish who will have the worst neurodevelopmental outcomes in childhood among babies born SGA. METHODS: The present analysis was conducted in Generation R, a population-based cohort in Rotterdam, the Netherlands (N = 5,487). Using group-based trajectory modeling, we identified fetal growth trajectories for weight among babies born SGA. These were based on standard deviation scores of ultrasound measures from mid-pregnancy and late pregnancy in combination with birth weight. We compared child nonverbal intelligence quotient (IQ) and attention deficit hyperactivity disorder (ADHD) symptoms at age 6 between SGA babies within each growth trajectory to babies born non-SGA. RESULTS: Among SGA individuals (n = 656), we identified three distinct fetal growth trajectories for weight. Children who were consistently small from mid-pregnancy (n = 64) had the lowest IQ (7 points lower compared to non-SGA babies, 95% confidence interval [CI] = -11.0, -3.5) and slightly more ADHD symptoms. Children from the trajectory that started larger but were smaller at birth showed no differences in outcomes compared to children born non-SGA. CONCLUSIONS: Among SGA children, those who were smaller beginning in mid-pregnancy exhibited the worst neurodevelopmental outcomes at age 6. Fetal growth trajectories may help identify SGA babies who go on to have poor neurodevelopmental outcomes.
BACKGROUND: Being born small for gestational age (SGA, <10th percentile) is a risk factor for worse neurodevelopmental outcomes. However, this group is a heterogeneous mix of healthy and growth-restricted babies, and not all will experience poor outcomes. We sought to determine whether fetal growth trajectories can distinguish who will have the worst neurodevelopmental outcomes in childhood among babies born SGA. METHODS: The present analysis was conducted in Generation R, a population-based cohort in Rotterdam, the Netherlands (N = 5,487). Using group-based trajectory modeling, we identified fetal growth trajectories for weight among babies born SGA. These were based on standard deviation scores of ultrasound measures from mid-pregnancy and late pregnancy in combination with birth weight. We compared child nonverbal intelligence quotient (IQ) and attention deficit hyperactivity disorder (ADHD) symptoms at age 6 between SGA babies within each growth trajectory to babies born non-SGA. RESULTS: Among SGA individuals (n = 656), we identified three distinct fetal growth trajectories for weight. Children who were consistently small from mid-pregnancy (n = 64) had the lowest IQ (7 points lower compared to non-SGA babies, 95% confidence interval [CI] = -11.0, -3.5) and slightly more ADHD symptoms. Children from the trajectory that started larger but were smaller at birth showed no differences in outcomes compared to children born non-SGA. CONCLUSIONS: Among SGA children, those who were smaller beginning in mid-pregnancy exhibited the worst neurodevelopmental outcomes at age 6. Fetal growth trajectories may help identify SGA babies who go on to have poor neurodevelopmental outcomes.
Authors: Jozien C Tanis; Meike H van der Ree; Elise Roze; Anna E Huis in 't Veld; Paul P van den Berg; Koenraad N J A Van Braeckel; Arend F Bos Journal: Pediatr Res Date: 2012-10-04 Impact factor: 3.756
Authors: Helen Leonard; Natasha Nassar; Jenny Bourke; Eve Blair; Seonaid Mulroy; Nicholas de Klerk; Carol Bower Journal: Am J Epidemiol Date: 2007-09-26 Impact factor: 4.897
Authors: Carolina C V Silva; Hanan El Marroun; Sara Sammallahti; Meike W Vernooij; Ryan L Muetzel; Susana Santos; Vincent W V Jaddoe Journal: JAMA Netw Open Date: 2021-12-01