Early Postnatal Weight Gain, Intellectual Performance, and Body Mass Index at 7 Years of Age in Term Infants with Intrauterine Growth Restriction

• Published in: The Journal of pediatrics Vol. 154; no. 2; pp. 201 - 206
• Main Authors: Pylipow, Mary, MD, Spector, Logan G., PhD, Puumala, Susan E., MS, Boys, Christopher, PhD, Cohen, Jessica, BS, Georgieff, Michael K., MD
• Format: Journal Article
• Language: English
• Published: Maryland Heights, MO Mosby, Inc 01.02.2009; Elsevier
• Subjects: Biological and medical sciences; Birth Weight - physiology; Body Mass Index; Child; Child Development - physiology; Diseases of mother, fetus and pregnancy; Female; Fetal Growth Retardation - physiopathology; General aspects; Gynecology. Andrology. Obstetrics; Humans; Infant; Intelligence; Linear Models; Male; Medical sciences; Pediatrics; Pregnancy; Pregnancy. Fetus. Placenta; Prospective Studies; Risk Factors; Wechsler Scales; Weight Gain - physiology; SES; CPP; DOHaD; Socioeconomic status; FTT; WISC; SGA; Developmental origins of health and disease; Body mass index; Intrauterine growth restriction; Failure to thrive; Appropriate for gestational age; IUGR; Collaborative Perinatal Project; AGA; Small for gestational age; BMI; Wechsler Intelligence Scale for Children; Human; Pediatrics; Intrauterine growth retardation; Pregnancy disorders; Weight gain; Growth retardation; Fetal diseases; Fetal development; Newborn; Postnatal; Term pregnancy; Early; Intellectual ability; Age
• ISSN: 0022-3476; 1097-6833
• DOI: 10.1016/j.jpeds.2008.08.015

Objective To determine whether the postnatal growth rate of infants with intrauterine growth restriction (IUGR) is associated with later cognitive function and body mass index (BMI). Study design Infants with IUGR (<2211 g at ≥37 weeks' gestation) were identified in data from the Collaborative Perinatal Project, excluding those with diagnoses affecting cognition or growth. Wechsler Scale of Children's Intelligence (WISC) scores at age 7 years and data on postnatal growth at 16 weeks were available for 463 infants with IUGR. Linear regression relating postnatal growth and WISC score, adjusting for potential confounders, was performed for these infants. BMI at 7 years also was examined. Results Weight gain at 16 postnatal weeks ranged from 1059 to 5119 g in the infants with IUGR, with lower achieved cognitive testing scores apparent at both extremes (ie, an inverted J-shape; P < .001). Infants gaining 1200 and 5000 g scored 15.5 and 2.4 fewer points, respectively, on the full scale compared with infants with score-maximizing growth. In contrast, BMI at 7 years was linearly related to postnatal weight gain ( P < .001). Conclusions Growth in the first 4 postnatal months is an independent risk factor for cognitive outcome at age 7 years, with both extremes associated with negative effects.