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PLoS One. 2016 Aug 8;11(8):e0160677. doi: 10.1371/journal.pone.0160677. eCollection 2016.

Etiological Subgroups of Small-for-Gestational-Age: Differential Neurodevelopmental Outcomes.

Author information

1
Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China.
2
Division of Behavioral Medicine, Department of Pediatrics, University at Buffalo, State University of New York, Buffalo, NY, 14214, United States of America.
3
Research Institute on Addictions, University at Buffalo, State University of New York, Buffalo, NY, 14203, United States of America.
4
Maternal and Child Health Program, School of Public Health, University of Maryland, College Park, MD, 20742, United States of America.
5
Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, 20742, United States of America.
6
Department of Epidemiology, School of Public Health, Brown University, Providence, RI, 02912, United States of America.
7
Department of Cancer Prevention Research, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province 510060, China.

Abstract

OBJECTIVES:

It remains unclear why substantial variations in neurodevelopmental outcomes exist within small-for-gestational-age (SGA) children. We prospectively compared 5-y neurodevelopmental outcomes across SGA etiological subgroups.

METHODS:

Children born SGA (N = 1050) from U.S. Early Childhood Longitudinal Study-Birth Cohort (2001-2007) was divided into etiological subgroups by each of 7 well-established prenatal risk factors. We fit linear regression models to compare 5-y reading, math, gross motor and fine motor scores across SGA subgroups, adjusting for socio-demographic confounders.

RESULTS:

Compared to singleton SGA subgroup, multiple-birth SGA subgroup had lower mean reading (adjusted mean difference, -4.08 [95% confidence interval, -6.10, -2.06]) and math (-2.22 [-3.61, -0.84]) scores. These disadvantages in reading and math existed only among multiple-birth SGA subgroup without ovulation stimulation (reading, -4.50 [-6.64, -2.36]; math, -2.91 [-4.37, -1.44]), but not among those with ovulation stimulation (reading, -2.33 [-6.24, 1.57]; math 0.63 [-1.86, 3.12]). Compared to singleton SGA subgroup without maternal smoking and inadequate gestational weight gain, singleton SGA subgroup with co-occurrence of maternal smoking and inadequate gestational weight gain (GWG) had lower mean reading (-4.81 [-8.50, -1.12]) and math (-2.95 [-5.51, -0.38]) scores. These differences were not mediated by Apgar score.

CONCLUSIONS:

Multiple-birth SGA subgroups (vs. singleton SGA) or singleton SGA subgroup with co-occurrence of smoking and inadequate GWG (vs. singleton SGA subgroup without maternal smoking and inadequate gestational weight gain) have poorer cognitive development up to 5 y.

PMID:
27501456
PMCID:
PMC4976943
DOI:
10.1371/journal.pone.0160677
[Indexed for MEDLINE]
Free PMC Article

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