Perinatal predictors of neurodevelopmental outcome in small-for-gestational-age children at 18 months of age.

Abstract

Our purpose was to explore the influence of a range of perinatal variables on neurodevelopment at 18 months in a cohort of small-for-gestational-age (SGA) children born in the mid 1990s. Two hundred eighty-two SGA children (birth weight <10th centile) were followed up prospectively; 220 (78%) had Bayley Scales of Infant Development II performed at 18 months' corrected age. The mean (SD) gestation at delivery was 36.5 (2.7) weeks and mean birth weight was 2095 (549) g. The mean Bayley Scales of Infant Development scores were as follows: Mental Developmental Index score, 95.6 (14.5); Psychomotor Developmental Index score, 97.9 (14.8); and Behavioural Rating Scale score, 110.6 (13.5). SGA children whose mothers had pregnancy-induced hypertension were less likely to have low Mental Development Index scores than SGA children whose mothers were normotensive during pregnancy (10 [23%] vs 78 [44%]. P =.01). Low Psychomotor Development Index scores were associated with not being breast-fed at 3 months (odds ratio [OR] 3.5; 95% CI 1.2-10.1) and long neonatal nursery stay (OR 2.8, 95% CI 1.02-7.05). A low Behavioral Rating Scale score was associated with a large z score for head circumference at birth (OR 2.4, 95% CI 1.2-4.8) and cord arterial base deficit (OR 1.2, 95% CI 1.01-1.4). Few of the perinatal variables previously reported are predictive of early childhood outcome in this modern cohort of SGA infants.