Cognitive and Behavioral Outcomes of Intrauterine Growth Restriction School-Age Children

• Published in: Pediatrics (Evanston) 2016-04, Vol.137 (4), p.1-1
• Main Authors: Chen, Juncao, Chen, Pingyang, Bo, Tao, Luo, Kaiju
• Format: Article
• Language: English
• Subjects: Analysis; Attention Deficit Disorder with Hyperactivity - etiology; Behavior; Behavior disorders; Birth weight; Case-Control Studies; Child; Child Behavior; Children & youth; Cognition; Cognition & reasoning; Fetal growth retardation; Fetal Growth Retardation - psychology; Fetus; Growth retardation; Health aspects; Humans; Intelligence; Intelligence Tests; Pediatrics; Physical growth; Prenatal development; Risk factors; Sick children
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.2015-3868

Children who experienced intrauterine growth restriction (IUGR) may be at increased risk for adverse neurologic developmental outcomes during the school-age years of life. To estimate the effect of IUGR on cognition and behavior in school-aged children. Medline, Embase, and PsycINFO were searched for English-language articles published after 1980. We included case-control studies reporting cognitive and/or behavioral data of children who had IUGR and were evaluated afterfifth birthday. Cognitive data from 15 studies and behavioral data from 6 studies were selected with a total of 1559 cases and 1630 controls. The cognitive scores and behavioral outcomes were extracted. The controls had significantly higher cognitive scores than the children with IUGR (standardized mean difference [SMD] -0.38, 95% confidence interval [CI] -0.51 to -0.25, P < .00001). The IQ scores of the IUGR group were not significantly correlated with mean birth weight and gestational age (P > .05). Five trials were included in the behavioral outcomes trial, the behavior scores were significantly different between the groups with and without IUGR (SMD 0.31, 95% CI 0.13 to 0.48, P = .001). The incidence of attention-deficit/hyperactivity disorder (ADHD) was not significantly different between 2 groups (P = .11). The number of studies that assessed behavioral and ADHD outcome is small. The findings demonstrate that IUGR is associated with lower cognitive scores in school-age children. However, further large-scale trials are needed to assess the effects of IUGR on the outcome of behavioral disorder and ADHD.