Axonal loss and cognitive deficits in term infants with normal umbilical artery Doppler born small-for-gestational age.

Abstract

To assess cognitive outcomes and structural changes in the central nervous system, the latter using a novel approach to examine changes in neuronal integrity of the optic nerve, in children at 5-6½ years of age who were born small-for-gestational age (SGA) at term having shown normal umbilical artery (UA) Doppler. We compared neuronal damage, cognitive deficits and visuospatial perception in two cohorts of infants, one born SGA (n = 40) and one born appropriate-for-gestational age (AGA) (n = 39) in weight. Neuronal damage was evaluated using optical coherence tomography (OCT) of the optic nerve. Cognitive deficits were assessed with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) test. Visuospatial perception was evaluated with Rey-Osterreich Complex Figure (ROCF) tasks. Children from the SGA group had a significantly thinner average retinal nerve fiber layer (RNFL) compared with those from the AGA group (98.2 vs 104.5 µm, P = 0.012). Children from the SGA group exhibited impaired performance in copy tasks on the ROCF (3.27 vs 3.56, P = 0.036) and a higher rate of suboptimal WPPSI test performance intelligence quotient scores (15% vs 0%; P = 0.025) compared with those from the AGA group. Term infants with normal UA Doppler born SGA are at increased risk for cognitive deficits and axonal loss in the RNFL at the age of 5-6½ years.