A case–control study to examine the association between breastfeeding during late pregnancy and risk of a small‐for‐gestational‐age birth in Lima,Peru

Excessive demands on maternal nutritional status may be a risk factor for poor birth outcomes. This study examined the association between breastfeeding during late pregnancy (≥28 weeks) and the risk of having a small‐for‐gestational‐age (SGA) newborn, using a matched case–control design (78 SGA cases: birthweight <10th percentile for gestational age; 150 non‐SGA controls: 50th percentile <birthweight <90th percentile for gestational age). Between March 2006 and April 2007, project midwives visited daily three government hospitals in Lima, Peru and identified cases and matched controls based on hospital, gestational age, and inter‐gestational period. Mothers were interviewed and clinical chart extractions were completed. Factors associated with risk of SGA were assessed by their adjusted odds ratios (aOR) from conditional logistic regression. Exposure to an overlap of breastfeeding during late pregnancy was not associated with an increased risk of having a SGA newborn [aOR = 0.58, 95% confidence interval (CI): 0.10–3.30]. However, increased risk was associated with having a previous low‐birthweight birth (aOR = 6.53; 95% CI: 1.43–29.70) and a low intake of animal source foods (<25th percentile; aOR = 2.26; 95% CI: 1.01–5.04), and tended to be associated with being short (<150 cm; aOR = 2.05; 95% CI: 0.92–4.54). This study found no evidence to support the hypothesis that breastfeeding during late pregnancy increases the risk for SGA; however, studies with greater statistical power are needed to definitively examine this possible association and clarify whether there are other risks to the new baby, the toddler and the pregnant woman.     

成都市9~15岁儿童出生情况与体格指标流行病学调查

目的：宫内环境可能对儿童生长发育产生影响,通过流行病学调查研究四川省成都市9~15岁儿童出生胎龄、体重与体格发育指标的关系。方法：调查9~15岁的中小学学生共7194名,根据出生胎龄及体重对儿童进行分类（包括小于胎龄儿、适于胎龄儿、大于胎龄儿）,测量身高、体重,并对其家长进行问卷调查。结果：被调查人群小于胎龄儿发生率为6.23%（448例）,其中身高未出现“追赶生长”（低于均值两个标准差）为5.13%,且多个年龄段儿童平均身高低于适于胎龄儿（P<0.05）。大于胎龄儿发生率为18.06% (1299例),大于胎龄儿中超重发生率为13.78% (179 例),肥胖发生率为4.39%（57例）,且多个年龄段儿童平均体重大于适于胎龄儿（P<0.05）。结论：出生时为小于胎龄儿、大于胎龄儿的儿童在远期生长发育中,可以出现身高和体重异于正常儿童,应关注这类孩子在学龄期的身高体重发育情况。     

Growth of 519 Small for Gestational Age Infants during the First Two Years of Life

ABSTRACT. The physical growth of 519 small for gestational age infants (SGA), with a birth weight below the 10th percentile on our own growth curve, born in the region of University Central Hospital of Turku during the period June 1,1981-May 31, 1982, was studied. The study population consists of 4 517 term, appropriate for gestational age (AGA) infants, 488 term SGA infants, 320 preterm AGA infants and 31 preterm SGA infants. The degree of intrauterine growth retardation (IUGR) seemed to have an effect on physical growth in term SGA infants. Those term SGA infants with a low Ponderal Index (PI) (type II) were taller and had a larger head circumference at the age of 24 months than term SGA infants with adequate PI (type I). Among the preterm SGA infants the degree of IUGR seemed to have no effect on later growth. Smoking is still one of the main risk factors associated with poor intrauterine growth. In this study we also found that smoking has an effect on later growth; the children of smoking mothers were smaller than those of non-smoking mothers in the AGA group. Among the SGA infants the infants of non-smoking mothers were bigger than those of smoking mothers. This difference could be explained by other factors associated with SGA. We found that in spite of the catch-up growth during the first months, 26% of the severely SGA infants (birth weight below the 2.5th percentile) still had a weight below the 2.5th percentile at the age of 24 months.     

Low‐birthweight rates higher among Bangladeshi neonates measured during active birth surveillance compared to national survey data

Birth size is an important gauge of fetal and neonatal health. Birth size measurements were collected within 72 h of life for 16 290 live born, singleton infants in rural Bangladesh from 2004 to 2007. Gestational age was calculated based on the date of last menstrual period. Newborns were classified as small‐for‐gestational age (SGA) based on a birthweight below the 10th percentile for gestational age, using three sets of US reference data. Birth size distributions were explored based on raw values as well as after z‐score standardisation in reference to World Health Organization (WHO) 2006 growth standards. Mean (SD) birthweight (g), length (cm) and head circumference (cm) measurements, completed within [median (25th, 75th percentile)] 15 (8, 23) h of life, were 2433 (425), 46.4 (2.4) and 32.4 (1.6), respectively. Twenty‐two per cent were born preterm. Over one‐half (55.3%) of infants were born low birthweight; 46.6%, 37.0% and 33.6% had a weight, length and head circumference below ?2 z‐scores of the WHO growth standard at birth; and 70.9%, 72.2% and 59.8% were SGA for weight based on Alexander et al., Oken et al. and Olsen et al. references, respectively. Infants in this typical rural Bangladesh setting were commonly born small, reflecting a high burden of fetal growth restriction and preterm birth. Our findings, produced by active birth surveillance, suggest that low birthweight is far more common than suggested by cross‐sectional survey estimates. Interventions that improve fetal growth during pregnancy may have the largest impact on reducing SGA rates.     

早产和低出生体重及小于胎龄儿与脑性瘫痪发病的关系

目的 明确早产、低出生体重及小于胎龄儿(SGA)与脑性瘫痪(简称脑瘫)的关联程度。方法 1997年5—7月对江苏省7个市的1～6岁儿童进行了现况普查,共查305263名,并对其胎龄、出生体重及胎龄别出生体重与脑瘫的关系进行了分析。结果 本组儿童共发现脑瘫484例,发生率为1．59‰。早产儿及过期产儿脑瘫发生率相对危险性(RR)分别为足月儿的25．16倍及2．40倍;低出生体重及巨大儿的脑瘫发生率RR分别为正常出生体重儿的19．63倍及1．34倍;SGA及大于胎龄儿(LGA)脑瘫发生率RR为适于胎龄儿(AGA)的4．34倍及0．84倍。先按胎龄别出生体重分层再按胎龄分组,发现各层内早产儿脑瘫发生率均较足月儿高,RR最高AGA层为28．34倍,其次LGA层为21．41倍,最低SGA层为9．29倍,各层内过期产儿脑瘫发生率也较足月儿高,RR最高AGA层为2．63倍,其次SGA层为1．90倍,最低LGA层为1．55倍;先按胎龄分层再按胎龄别出生体重分组发现各层内SGA脑瘫发生率均较AGA高,RR最高足月儿层为4．41倍,其次过期产儿层为3．19倍,最低早产儿层为1．45倍,各层内LGA脑瘫发生率均不比AGA高,除足月儿层相近为0．98倍外,早产儿及过期产儿层均较AGA低,RR分别为0．74倍和0．58倍。按胎龄大小及胎龄别出生体重大小联合分成9组进行比较,发现多数组脑瘫发生率均较足月AGA组高,RR按次序为早产SGA40．99倍、早产AGA28．34倍、早产LGA21．08倍、过期SGA8．39倍、足月SGA4．41倍、过期AGA2．63倍、过期LGA1．53倍、足月LGA0．98倍;前6组差异均有显著性,后2组倍数接近1．0,差异无显著性。结论 早产及SGA两种因素均与小儿脑瘫发生率增加关联,这两个因素分别为小儿脑瘫独立的危险因素;过期产与脑瘫的关联很弱,LGA则与脑瘫的发生率增加无关。     

Fetal and neonatal mortality of small-for-gestational age infants

Fetal and neonatal mortality of small-for-gestational age (SGA) infants in 1968–1982 were studied in the region of the University Central Hospital of Turku, Finland. During the study period, there were 254 fetal and 127 neonatal deaths in SGA infants. The fetal mortality rate of SGA infants declined from 49.9/1000 to 14.0/1000. The neonatal mortality rate of SGA infants declined from 23.8/1000 to 8.3/1000. The severely SGA infants with a birth weight below the 2.5th percentile had three times higher neonatal mortality rates than SGA infants with a birth weight between the 2.5th and the 10th percentiles. The main causes of fetal deaths were maternal diseases, placental and cord complications and fetal malnutrition, even though there was a decline in all these groups. Malformations remained the main cause of neonatal death during the study period, while there was a decline in deaths due to asphyxia and respiratory distress syndrome (RDS). The high mortality rates of SGA infants emphasize the need for early diagnosis and special attention during pregnancy, delivery and the neonatal period.Abbreviations SGA small-for-gestational age - AGA appropriate-for-gestational age - UCHT University Central Hospital of Turku - RDS respiratory distress syndrome     

A 14-Year Follow-Up of Children with Normal and Abnormal Birth Weight for Their Gestational Age

ABSTRACT. Mortality, major neurological handicaps-including mental retardation, cerebral palsy and epilepsy-educational subnormality and height at 14 years of age were studied by birth weight percentiles in a birth cohort of 12000 children from northern Finland. Infant mortality was significantly higher below the mean -2 SD, 10th and 25th percentiles, than in the median class, from 25th to 75th percentiles, but mortality from one to 14 years only in the lowest weight class. Educational subnormality, including mental retardation ± some other handicap, was highly significantly more frequent in all the percentile classes lower than the median class but showed no significant tendency to be less frequent in the percentiles over the median. It was also highly significantly more frequent among the preterm than the term infant. The number of children with a major neurological handicap but normal school performance did not vary significantly by birth weight percentiles or by gestational age. Height at 14 years increased significantly by birth weight percentiles. The height of the boys with birth weight mean - and +2 SD was nevertheless within the 25th-75th percentiles for height at 14 years in general, while the height of the girls came close to these percentile limits. The preterm infants were significantly shorter than the term infants at 14 years.     

Maternal selenium,copper and zinc concentrations in pregnancy associated with small‐for‐gestational‐age infants

Pregnancy during adolescence increases the risk of adverse pregnancy outcome, especially small‐for‐gestational‐age (SGA) birth, which has been linked to micronutrient deficiencies. Smoking has been shown to be related to lower micronutrient concentrations. Different ethnicities have not been examined. We used a subset from a prospective observational study, the About Teenage Eating study consisting of 126 pregnant adolescents (14–18‐year‐olds) between 28 and 32 weeks gestation. Micronutrient status was assessed by inductively coupled mass spectrometry. Smoking was assessed by self‐report and plasma cotinine, and SGA was defined as infants born <10th corrected birthweight centile. The main outcome measures were as follows: (1) maternal plasma selenium, copper and zinc concentrations in adolescent mothers giving birth to SGA vs. appropriate‐for‐gestational‐age (AGA) infants; and (2) comparison of micronutrient concentrations between women of different ethnicities and smoking habits. The plasma selenium {mean ± standard deviation (SD) [95% confidence interval (CI)]} concentration was lower in the SGA [n = 19: 49.4 ± 7.3 (CI: 45.9, 52.9) µg L^?1] compared with the AGA [n = 107: 65.1 ± 12.5 (CI: 62.7, 67.5) µg L^?1; P < 0.0001] group. Smoking mothers had a lower selenium concentration compared with non‐smokers (P = 0.01) and Afro‐Caribbean women had higher selenium concentrations compared with White Europeans (P = 0.02). Neither copper nor zinc concentrations varied between groups. Low plasma selenium concentration in adolescent mothers could contribute to the risk of delivering an SGA infant, possibly through lowering placental antioxidant defence, thus directly affecting fetal growth. Differences in plasma selenium between ethnicities may relate to variation in nutritional intake, requiring further investigation.     

Placental IGF-I, IGFBP-1, zinc, and iron, and maternal and infant anthropometry at birth

Aim: To correlate placental protein levels of insulin‐like growth factor (IGF)‐I and insulin‐like growth factor binding protein (IGFBP)‐1, with previously determined levels of IGF‐I and IGF‐II mRNA expression, and the micronutrients zinc and iron, and maternal and newborn anthropometry. Methods: Placental samples were collected from rural field sites in Pakistan. Samples were divided into small and large for gestational age groups (SGA and LGA, respectively). IGFBP‐1 levels were assessed using Western immunoblotting. IGF‐I protein levels were assessed using ELISA techniques. IGF mRNA expression, zinc, and iron, were quantified as previously described and were used for comparative purposes only. Results: Thirty‐three subjects were included (SGA, n = 12; LGA n = 21). Higher levels of IGFBP‐1 were seen in the SGA group (p < 0.01). IGFBP‐1 correlated positively with maternal and infant triceps skin‐fold thickness in the LGA and SGA groups, respectively (p < 0.05). Significantly lower IGF‐I protein levels were seen in the SGA group. IGF‐I levels correlated significantly with maternal and newborn anthropometry. IGFBP‐1 correlated significantly with IGF‐II mRNA expression (p < 0.05). Conclusion: Placental protein levels of IGF‐I and IGFBP‐1 appear to be associated with maternal anthropometry. Maternal anthropometry may thus influence IGFBP‐1 and IGF‐I levels and may possibly be used for screening of pregnancies, with the potential for timely identification of these high‐risk pregnancies.     

Postnatal growth in VLBW infants: significant association with neurodevelopmental outcome

OBJECTIVE: To study the significance of growth status at birth and postnatal growth on neurodevelopmental outcome in very low birth weight (VLBW) infants. STUDY DESIGN: Growth and neurodevelopment were examined in 219 VLBW (<1250 g) children, 94 small for gestational age (SGA) (<10th percentile) and 125 appropriate for gestational age (AGA) (>10th percentile). Outcome at age 2 was assessed with the Bayley Scales of Infant Development (Mental Developmental Index [MDI], Psychomotor Developmental Index [PDI]) and a standardized neurologic examination. RESULTS: SGA status was not associated with poor neurodevelopmental outcome. However, after adjustment for covariables including cerebral palsy (CP), SGA children with weight <10th percentile at age 2 had lower mean PDI than SGA children with catch-up growth to weight >10th percentile (mean [SD], 89.9 [17.4] versus 101.8 [14.5]; P<.001). AGA children with catch-down growth (weight <10th percentile at age 2) were, independent of CP, more likely to have lower mean MDI (94.9 vs 101.7, P=.05) and PDI (81.9 vs 95.1; P<.001) than AGA children remaining >10th percentile at age 2. They also more frequently had severe CP (22.9% vs 1.2%; P=.008). CONCLUSIONS: In VLBW children, the course of postnatal growth rather than the appropriateness of weight for gestational age at birth determines later neurodevelopmental outcome.     

匀称型和非匀称型婴儿智能发育观察

目的根据中华儿科杂志小于胎龄儿(SGA)的临床分型对43例SGA进行临床分型并观察其智能发育情况。 方法应用Bayley婴儿发育量表对不同临床分型的SGA婴儿的智能发育进行评价。 结果匀称型SGA其两种临床分型方法的符合率达到72．09％,而体重、头围和身高均在该胎龄值的第10百分位以下婴儿仅占32．56％,其精神发育指数(MDI)和心理运动发育指数(PDI)均较低。匀称型SGA的MDI和PDI高于非匀称型。 结论对目前SGA的临床分型方法尚需商榷。     

Breastfeeding and intelligence of preschool children

AIM: To investigate whether breastfeeding during infancy is a determinant of intelligence at 3.5 y. METHODS: Five hundred and fifty European children enrolled at birth in the Auckland Birthweight Collaborative Study were assessed at 3.5 y of age. Approximately half were small for gestational age (SGA < or =10th percentile) at birth and half were appropriate for gestational age (AGA >10th percentile). Duration of breastfeeding was recorded at maternal interview, and the intelligence of children was assessed using the Stanford Binet Intelligence Scale. Regression analysis was used to calculate estimates of difference in intelligence scores between breastfeeding groups for the total sample and the group of SGA children. Analyses of the total sample were weighted to account for the disproportionate sampling of SGA children. RESULTS: Breastfeeding was not significantly related to intelligence scores in the total sample despite a trend for longer periods of breastfeeding to be associated with higher intelligence scores. However, in the SGA group, breastfeeding was significantly related to IQ at 3.5 y. Small for gestational age children who were breastfed for longer than 12 mo had adjusted scores 6.0 points higher than those who were not breastfed (p=0.06). CONCLUSION: Breastfeeding may be particularly important for the cognitive development of preschool children born small for gestational age.     

Children born small for gestational age are not at special risk for preschool emotion and behaviour problems

Despite the wealth of literature examining long term outcomes of preterm low birthweight children, few studies have directly assessed the developmental impact of being born full term but small for gestational age (SGA). We aim to determine whether (i) being SGA increases preschool behavioural problems and (ii) other risk factors operate differently in SGA and appropriate for gestational age (AGA) controls. 550 New Zealand European mothers and their 3.5 year old children participated in this study. All children were born at full term (>37 weeks' gestation) and approximately half were SGA (≤sex specific 10th percentile for gestation) the remainder were AGA controls. Extensive data were collected at the child's birth, 1 year and 3.5 years. Behavioural problems were measured when children were 3.5 years, using the Strengths and Difficulties Questionnaire (SDQ). Multiple regression analyses were used to examine the associations between risk factors and behavioural problems; statistical weighting was used for analyses of the total study group. There was no significant difference in behavioural problems between SGA and AGA groups. In the total sample the significant predictors of behavioural problems included: mothers' school leaving age; smoking during pregnancy; maternal alcohol use during pregnancy; and absence of the father. Predictors of behavioural problems were found to be the same for SGA and AGA groups. These results do not support the view that SGA is a risk for behavioural preschool difficulties or that SGA children are sensitised to risks known to be associated with such difficulties in the preschool years.     

Risk factors for small-for-gestational-age babies: The Auckland Birthweight Collaborative Study

OBJECTIVE: This case-control study determined whether internationally recognized risk factors for small-for-gestational-age (SGA) term babies were applicable in New Zealand. METHODOLOGY: All babies were born at 37 or more completed weeks of gestation in one of three hospitals in Auckland. Cases weighed less than the sex specific 10th percentile for gestational age at birth, and controls (appropriate-for-gestational-age (AGA)) were a random selection of heavier babies. Information was collected by maternal interview and from obstetric databases. RESULTS: Information from 1714 completed interviews (844 SGA and 870 AGA) was available for analysis. Computerized obstetric records were available for 1691 of the 1701 women who consented to such access. In a multivariate analysis allowing for sex, gestational age at birth, social class and other potential confounders, mothers who smoked had a significantly increased risk of an SGA baby (adjusted OR 2.41; 95% CI 1.78-3.28), as did primiparous mothers (adjusted OR 1.34; 95% CI 1.03-1.73), mothers of Indian ethnicity (adjusted OR 3.22; 95% CI 1.95-5.30), women with pre-eclamptic toxaemia (adjusted OR 2.42; 95% CI 1.08-5.40) and those with pre-existing hypertension toxaemia (adjusted OR 5.49; 95% CI 1.81-16.71). Mothers of SGA infants were shorter (P < 0.001) and reported lower prepregnancy body weights (P < 0.001) than mothers of AGA infants. The population attributable fraction for smoking suggests that up to 18% of SGA infants born in the ABC Study could be related to maternal smoking. CONCLUSIONS: Risk factors associated with SGA births in other countries are also important in New Zealand. Smoking in pregnancy is an important and potentially modifiable behaviour, and efforts to decrease the number of women who smoke during pregnancy should be encouraged.     

Proportionality at Birth

ABSTRACT. 501 small (SGA), 330 average (AGA) and 460 large for gestational age (LGA) babies were measured at birth. Head-chest, head-crown-rump length, and chest-crown-rump length ratios were used to evaluate the changing patterns of proportionality with increasing gestational age. The SGA group showed strong negative correlations for head-chest and head-length ratios, and positive correlations for chest-length ratios. The patterns were similar in the AGA group, only less evident. For all three measures of proportionality, correlations with gestational age in the LGA group were close to zero. In each group boys had higher head-chest ratios than girls.     

Foetal size and body proportion at 17-19 weeks of gestation and neonatal size, proportion, and outcome

OBJECTIVE: To determine whether proportionate or disproportionate foetal smallness at 17 to 19 weeks of gestation in low-risk pregnancies was associated with size, body constitution, and adverse outcome at birth. METHODS: We included ultrasound measurements at 17-19 weeks of gestation in 7285 uncomplicated pregnancies with reliable information on last menstrual period. We considered a foetus with both mean abdominal diameter (MAD) and biparietal diameter (BPD) below the 10th percentile for gestational age, gender, and parity as symmetrically small. Those who had MAD below the 10th percentile and BPD at or above the 10th percentile were asymmetrically small (thin and small). RESULTS: The occurrence of small for gestational age (SGA) (birth weight below the 10th percentile) decreased with increasing second trimester MAD percentile (P<0.0001). The risk in foetuses which were both thin and extremely small (MAD below the 2.5th percentile) of having weight, ponderal index, crown-heel length, or head circumference below the 10th percentile at birth was 19-28%. The risk of perinatal composite outcome (prenatal death, Apgar score after 5 min < or =7, birth weight below the 10th percentile, or <1500 g, or preterm birth) was 37%. Apgar score of < or =7 at 5 min and explained foetal death both occurred in 7%, which was significantly higher than those with larger MAD. CONCLUSION: Asymmetric as well as symmetric foetal smallness may start early in pregnancy. Symmetric and particularly asymmetric small foetuses at 17-19 weeks of gestation were generally lighter, shorter, and thinner at birth and had more often adverse perinatal outcome.     

Human placental IGF-I and IGF-II expression: correlating maternal and infant anthropometric variables and micronutrients at birth in the Pakistani population

Abstract Aim: To correlate infant birth weight with maternal and infant biometric data, including the expression of placental IGF-I and IGF-II at birth, and levels of serum zinc and ferritin. Methods: The data consisted of observations from 89 women from Karachi, Pakistan. Placental and cord blood samples were taken immediately following delivery and were subsequently divided into two groups, small and large for gestational age (SGA and LGA). Results: The mean birth weight was 2.79 kg; the prevalence of SGA being 13.4% (/=90th percentile). Placental IGF-I and IGF-II mRNA expression was greater in the LGA group (p < 0.05). Furthermore, a significant correlation was noted between infant birth weight and maternal anthropometric parameters (p < 0.01). Cord zinc levels were also significantly higher in the LGA group (p < 0.05). Conclusion: Maternal anthropometry, along with placental IGF-I and IGF-II mRNA levels, correlated significantly with infant birth weight suggesting the importance of these growth factors for birth weight outcomes. The higher zinc levels in the LGA group also suggest the importance of this micronutrient in foetal growth. Our results suggest that growth problems have a multifactorial aetiology arising from within the infant rather than due to maternal constraint alone.     

Mother-infant feeding interaction in full-term small-for-gestational-age infants

Maternal and infant behavior during feeding was assessed in 30 mother-infant dyads: 15 small-for-gestational-age (SGA) infants (birth weights below the 10th percentile) and 15 appropriate-for-gestational-age (AGA) infants (birth weights between the 25th and 90th percentiles). The groups were balanced for gestational age, sex, neonatal risk factors, and maternal age, parity, socioeconomic status, and race. Behaviors indicative of infant feeding difficulties were coded for mother and infant. The SGA mothers had higher frequencies of these behaviors than did their AGA counterparts. Qualitative ratings of interactive behavior were recorded for mother and infant: SGA infants had ratings indicative of less optimal interactions than those of the AGA group. Infant caloric intake (calories per kilogram per feeding) was calculated by first dividing the change in infant weight in grams before feeding and immediately after feeding by the infant's weight before feeding and then converting it to calories. Although no difference in caloric intake was observed between the two groups, infant behaviors and ratings were associated with caloric intake. These data suggest the importance of including neonatal behavior during feeding in the risk assessment of potential growth failure in SGA infants.     

Psychiatric morbidity in two low birth weight groups assessed by diagnostic interview in young adulthood

Aim: To study the prevalence and characteristics of psychiatric symptoms and disorders in young adults born with low birth weight. Methods: At 20 years of age 44 very low birth weight (VLBW: birth weight ≤1500 g), 55 term born small for gestational age (SGA: birth weight <10th percentile) and 75 control subjects born 1986–1988 were assessed using the interview Schedule for Affective Disorders and Schizophrenia for School‐age children and Structured Clinical Interview for DSM‐IV Personality Disorders, Children’s Global Assessment Scale and Attention deficit hyperactivity disorder (ADHD) Rating Scale IV; self‐report and parent report. Results: Fourteen (33%) VLBW versus six (8%) control participants had a definite psychiatric disorder: OR = 5.6 (1.9–15.9). In the term SGA group, 14 (26%) had a disorder: OR = 3.9 (1.4–11.0) vs controls. Anxiety disorders and ADHD were the most frequent diagnoses. The differences were not explained by gender, assessment age or parental socioeconomic status. ADHD Rating Scale mean scores were higher in parent reports in the VLBW group and in self‐reports in the term SGA group compared with the control group. Conclusion: Children born with low birth weight whether caused by preterm birth or by growth retardation at term seem to be at increased risk for psychiatric disorders as young adults.     

Systematic review indicates postnatal growth in term infants born small‐for‐gestational‐age being associated with later neurocognitive and metabolic outcomes

We systematically reviewed papers published in English between 1994 and October 2015 on how postnatal weight gain and growth affect neurodevelopment and metabolic outcomes in term‐born small‐for‐gestational‐age (SGA) infants. Two randomised trials reported that enriched infant formulas that promoted early growth also increased fat mass, lean mass and blood pressure (BP), but had no effect on early neurocognitive outcomes. Meanwhile, 31 observational studies reported consistent positive associations between postnatal weight gain and growth with neurocognitive outcomes, adiposity, insulin resistance and BP. Conclusion: Few intervention studies exist, despite consistent positive associations between early growth and neurocognition in term‐born SGA infants.