Pathways of neuronal and cognitive development in children born small‐for‐gestational age or late preterm. (January 2014)

• Record Type: Journal Article
• Authors: Oros, D.; Altermir, I.; Elia, N.; Tuquet, H.; Pablo, L. E.; Fabre, E.; Pueyo, V.
• Is Part Of: Ultrasound in obstetrics & gynecology. Volume 43:Number 1(2014:Jan.)
• Page Start: 41
• Page End: 47
• Publication Date: 2014-01
• Subjects: Ultrasonics in obstetrics -- Periodicals; Generative organs, Female -- Diseases -- Diagnosis -- Periodicals; Diagnosis, Ultrasonic -- Periodicals; Genital Diseases, Female -- ultrasonography -- Periodicals; Ultrasonography, Prenatal -- Periodicals; 618.047543
• DOI: 10.1002/uog.12556
• Languages: English
• ISSNs: 0960-7692

Abstract

<abstract abstract-type="main" id="uog12556-abs-0001"> <title>ABSTRACT</title> <sec id="uog12556-sec-0001" sec-type="section"> <title>Objective</title> <p id="uog12556-para-0001"> <italic>To assess the effects of late small‐for‐gestational‐age (SGA) birth and late prematurity on cognitive outcomes and structural changes in the central nervous system at primary school age, using a novel approach to examine changes in neuronal integrity of the retina</italic>.</p> </sec> <sec id="uog12556-sec-0002" sec-type="section"> <title>Methods</title> <p id="uog12556-para-0002"> <italic>We conducted a cross‐sectional study of 347 children aged 6–13 years, including in the analysis only infants born after 34 weeks' gestation. We recorded all perinatal outcomes through a survey of parents. Neuronal damage was evaluated using optical coherence tomography of the retina. In a subgroup of 112 children aged 6–8 years, visuospatial perception was evaluated with the Children's Bender Visual Motor Gestalt Test</italic>.</p> </sec> <sec id="uog12556-sec-0003" sec-type="section"> <title>Results</title> <p id="uog12556-para-0003"> <italic>The proportions of SGA and late preterm children were 11.8 and 6.3%, respectively. Prematurity and SGA were simultaneously present in five children. When compared with controls, SGA children showed significantly lower than average retinal nerve fiber layer (RNFL) thickness (94.1</italic> vs <italic>98.8</italic> μ<italic>m</italic>; P = <italic>0.007) and an increased percentage of abnormal Bender scores (27.3</italic> vs <italic>6.2%</italic>; P = <italic>0.017) (odds ratio 5.6 (95% CI, 1.2–26.8)). These differences increased when late SGA infants with a birth weight below the 3<sup>rd</sup> percentile were compared with SGA infants with a birth weight between the 3<sup>rd</sup> and 10<sup>th</sup> percentiles and with controls, for RNFL thickness (92.5</italic> vs <italic>94.6 and 98.8</italic> μ<italic>m, respectively</italic>; P = <italic>0.021) and abnormal Bender tests (33.3</italic> vs <italic>25.0 and 6.2%, respectively</italic>; P = <italic>0.036). However, no differences were found in retinal structure and visuomotor performance between late preterm and term infants</italic>.</p> </sec> <sec id="uog12556-sec-0004" sec-type="section"> <title>Conclusions</title> <p id="uog12556-para-0004"> <italic>These data suggest that late SGA and late prematurity induce a distinct neuronal pattern of structural changes that persist at school age. Late‐onset SGA infants are at increased risk for axonal loss in the retina and present specific visuomotor difficulties. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd</italic>.</p> </sec> </abstract>