The neurodevelopmental outcome of term infants with different intrauterinegrowth characteristics

The objective of this study was to test the hypothesis that neurodevelopmen tal outcome would differ between two groups of small-for-gestational age in fants born at term showing different in utero growth characteristics during the third trimester. The design was a prospective cohort study done at a t ertiary referral centre. The 76 subjects who fulfilled the inclusion criter ia had an estimated fetal weight below the 10th centile for their gestation . Subsequent to enrolment, repeat ultrasound scans were performed weekly to determine growth velocity. Twenty-three infants whose change in fetal abdo minal circumference between first and last scan was greater than - 1.5 stan dard deviation scores (SDS) were assigned to the intrauterine growth retard ation group (IUGR) while 53 infants whose fetal abdominal circumference cha nged less than 1.5 SDS were assigned to the small-for-gestational-age (SGA) group. Ten infants with normal intrauterine growth were enrolled as contro ls. Following delivery all infants had a neurological examination and a cra nial ultrasound scan. At 1 year, 75 infants (87%) were traced and reassesse d (49 SGA, 18 IUGR and eight controls) with a neurological examination and a developmental assessment. At birth, impairments were found in 27 (51%) Of the SGA, 13 (57%) of the IUGR groups and one (10%) of the controls. At 1 y ear, 18 (37%) of the SGA subjects, six (33%) of the IUGR subjects and one ( 13%) of the control infant were impaired, including three (6%) of the SGA s ubjects and one (6%) of the IUGR subjects who were disabled. We conclude th at in term fetuses with an estimated birthweight below the 10th centile for their gestation, the pattern of growth in the third trimester does not aff ect outcome at 1 year. In spite of optimum obstetric management, nearly one -third of the combined SGA and IUGR term fetuses had suffered some, albeit minor, neurological damage. (C) 1999 Elsevier Science Ireland Ltd. All righ ts reserved.