Children Born Small for Gestational Age Face Higher Risk of Neurodevelopmental Disability by Age 5: Hokkaido Study
Children born small for their gestational age (SGA) are more likely to experience neurodevelopmental difficulties by the age of five, even if they are delivered at full term, according to a new study published in Pediatrics International.
The research, led by Dr. Satoshi Suyama and colleagues from the Funded Research Division of Child and Adolescent Psychiatry, Hokkaido University Hospital, sheds light on the long-term implications of restricted fetal growth on early childhood development.
Low birth weight has long been recognized as a factor contributing to delayed growth and developmental challenges. SGA, a clinical measure used to define infants whose weight falls below the expected range for their gestational age, has been associated with a range of neurodevelopmental disorders. However, the impact of being born SGA at full term (term-SGA) has been less clear.
To explore this, the investigators utilized data from the Hokkaido Study on Environment and Children’s Health, a large prospective birth cohort. The study targeted 4,851 children who reached the age of five between April 2008 and November 2011. Mothers were asked to complete questionnaires, including the widely used Strengths and Difficulties Questionnaire (SDQ), which evaluates behavioral and emotional challenges in children. Information on birth weights was cross-referenced with data from the Japan Pediatric Society to classify children as SGA or term-SGA. Out of the invited participants, 3,484 families responded.
The analysis revealed the following findings:
- Children born small for gestational age (SGA) showed notable differences compared to those with normal birth weight.
- Univariate analysis revealed significant variations in hyperactivity/inattention scores and overall Total Difficulties Scores (TDS).
- Multivariate analysis indicated that both SGA and term-SGA status were strongly linked to higher odds of neurodevelopmental disability, even after adjusting for sex and household income.
- Children with SGA status had a 75% greater risk of elevated TDS (OR = 1.75).
- Children born term-SGA had a 72% higher risk of elevated TDS (OR = 1.72).
- No significant association was found between SGA status and hyperactivity or inattention scores when assessed independently.
The findings highlight that being born small for gestational age, regardless of whether a child is preterm or full term, can have lasting implications on neurodevelopment. “Our results suggest that SGA, even at term, may predispose children to difficulties in emotional and behavioral development, as reflected in the SDQ scores,” the authors noted.
The study highlights the importance of early monitoring and interventions for children born SGA, to help mitigate potential developmental challenges during the crucial early years of growth. Given the rising global focus on child health and developmental outcomes, the researchers emphasize that identifying at-risk children at birth could play a critical role in ensuring timely support and improved long-term well-being.
Reference:
Suyama, S., Itoh, M., Tamura, N., Iwata, H., Yamaguchi, T., Kobayashi, S., Miyashita, C., Saito, T., & Kishi, R. (2024). Association between small for gestational age and neurodevelopmental disability at 5 years in the Hokkaido study. Pediatrics International, 67(1), e70137. https://doi.org/10.1111/ped.70137
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