SMALL-FOR-GESTATIONAL-AGE (SGA) INFANTS BORN AT TERM - GROWTH AND DEVELOPMENT DURING THE FIRST YEAR OF LIFE

Background. The purpose was to compare growth patterns and psychomotor development of healthy small-for-gestational-age (SGA) and non-SGA in fants, and identify factors predictive of outcome at 13 months of age. Method. A total of 265 SGA infants and 329 non-SGA controls were iden tified from a multicenter cohort of 5722 para 1 and 2 women who had be en followed during pregnancy. The infants were examined at 2 days and at 13 months of age. Psychomotor development at 13 months was assessed with The Bayley Scale of Infant Development. Results. The SGA infants showed partial catch-up growth, but had still lower (mean +/- SEM, p < 0.0001) weight (9750 +/- 65 vs 10505 +/- 67 g), crown-heel length (7 5.9 +/- 0.2 vs 77.5 +/- 0.2 cm) and head circumference (46.9 +/- 0.1 v s 47.7 +/- 0.1 cm) than the non-SGA infants at 13 months. The SGA chil dren scored equally well on the motor (PDI 106.8 +/- 1.0 vs 107.2 +/- 0.8) but lower on the mental scale (MDI 112.1 +/- 0.8 vs 116.5 +/- 0.7 , p < 0.0001) of the Bayley Scale, and the asymmetric SGA scored lower than the symmetric SGA infants (MDI 110.2 +/- 1.3 vs 113.3 +/- 0.9, p = 0.05). In a multivariate regression analysis the parents' growth pa rameters had the greatest effect on growth measures at 13 months while education and maternal smoking had no significant effect. SGA vs non- SGA status had the greatest effect on growth velocities during infancy . For mental development only SGA vs non-SGA status and the mothers' e ducation made significant contributions, but only accounted for 6% of the variance. Conclusion. The negative impact of intrauterine factors on growth are partly abolished by catch-up growth during infancy, and growth parameters at one year of age are mostly determined by genetic factors even in SGA infants. Decreased intrauterine growth may possibl y have a negative effect on brain growth and mental developmental pote ntial.