Cognitive Functioning and Academic Achievement in Children Aged 6-8 Years, Born at Term After Intrauterine Growth Restriction and Fetal Cerebral Redistribution

J Pediatr Psychol. 2017 Apr 1;42(3):345-354. doi: 10.1093/jpepsy/jsw060.

Abstract

Objective: To determine whether cerebroplacental ratio, an indicator of fetal cerebral redistribution (FCR), predicts adverse results for neurodevelopment in intrauterine growth restriction (IUGR) infants.

Methods: In a cohort of 5,702 infants, 64 were IUGR born at term with FCR. Five were excluded. Of the remainder, 32 presented an abnormal cerebroplacental ratio (IUGR-A) and 27 a normal one (IUGR-B). The controls were 61 appropriate-for-gestational-age children. Cognitive and academic outcomes and the odds ratio of lower academic scores were assessed by multivariate analysis of covariance and logistic regression.

Results: IUGR-A children presented deficits in cognitive functioning and academic achievement in all domains. IUGR-B children presented slight deficits. Suboptimal cognitive functioning in IUGR-A was more marked in working memory. Abnormal cerebroplacental ratio predicted low academic scores in IUGR-A.

Conclusions: FCR is a risk factor for IUGR infants, and cerebroplacental ratio identifies those most severely affected. Intervention programs may produce benefits in early-middle childhood.

Keywords: academic achievement; cerebral redistribution; cerebroplacental ratio; cognitive functioning; intrauterine growth restriction.

MeSH terms

  • Achievement*
  • Cerebral Arteries / embryology
  • Cerebral Arteries / physiopathology*
  • Child
  • Cognition Disorders / complications
  • Cognition Disorders / physiopathology*
  • Educational Status*
  • Female
  • Fetal Growth Retardation / physiopathology*
  • Humans
  • Infant, Newborn
  • Male
  • Retrospective Studies
  • Risk Factors
  • Umbilical Arteries / embryology
  • Umbilical Arteries / physiopathology*