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Impact of intrauterine growth restriction and birth weight on infant's early childhood neurodevelopment outcome
Fahad Al-Qashar1, Badr Sobaih2, Eman Shajira1, Saif Al Saif3, Ibrahim Abdelhakim Ahmed3, Hassan Al-Shehri4, Mosleh Jabari4, Abdullah Al-Faris5, Mohammed Al-Sayed5, Loaysobaih2, Kamal Ali3
1 Department of Pediatrics, Bahrain Defence Force Hospital, Royal Medical Services, Riffa, Bahrain
2 Department of Pediatrics, Division of Neonatology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
3 Department of Neonatal Intensive Care, King Abdulaziz Medical City, Ministry of National Guard - Health Affairs, Riyadh, Saudi Arabia
4 Department of Pediatrics, College of Medicine, Al-Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia
5 Department of Pediatrics, Security Forces Hospital, Riyadh, Saudi Arabia
Correspondence Address:
Dr. Fahad Al-Qashar
Department of Pediatrics, Bahrain Defence Force Hospital, Royal Medical Services, Riffa
Bahrain
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/jcn.JCN_16_17
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Background: Infants with intrauterine growth restriction (IUGR) are at increased risk of perinatal morbidity and mortality in addition to long-term neurodevelopmental impairment due to fetal, placental, or maternal causes. Aim: This study aims to evaluate early childhood neurodevelopmental outcome from 18 to 24 months of age following a pregnancy complicated by IUGR. Study Design: This is an observational cohort study of prospectively collected data from a neonatal follow-up program (NFP) at the King Khalid University Hospital, Riyadh, Saudi Arabia. Results: A total of 65 IUGR infants with a median gestational age (GA) of 36 weeks (28–40 weeks) and a median birth weight of 1595 g (740–2280 g) were enrolled in the NFP. The majority of the mothers were Saudi 63 (97%), with a mean age of 30 years (19–45 years). Sixty-five percent of the infants were born by cesarean section. The prevalence of IUGR was 5.5% with predominance of symmetrical IUGR pattern 52 (80%). The median age of developmental assessment was 15 months (7–33 months). Thirty-two infants (49.2%) had a lower score (moderate 23 (35.4%) and severe 9 (13.4%) by Bayley Infant Neurodevelopmental Screening (BINS). There were no correlations between BINS category and birth weight, GA, gender, or type of IUGR. Catch-up growth was achieved in 44 (66.7%) of the infants at a median age of 9 months. Conclusion: We have demonstrated a higher incidence of poor neurodevelopmental scores at the early ages from 15 to 24 months among infants who were born following a pregnancy complicated by IUGR. BINS scores were not influenced by birth weight, GA, gender, or type of IUGR. IUGR is an independent variable for poor neurodevelopmental outcome. These patients will be followed to preschool ages for further neurocognitive assessment.
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