RT Journal Article
SR Electronic
T1 Neurodevelopment assessment of small for gestational age children in a community-based cohort from Pakistan
JF Archives of Disease in Childhood
JO Arch Dis Child
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP archdischild-2022-324630
DO 10.1136/archdischild-2022-324630
A1 Naz, Sabahat
A1 Hoodbhoy, Zahra
A1 Jaffar, Ali
A1 Kaleem, Sidra
A1 Hasan, Babar S
A1 Chowdhury, Devyani
A1 Gladstone, Melissa
YR 2022
UL http://adc.bmj.com/content/early/2022/10/26/archdischild-2022-324630.abstract
AB Background Children born small for gestational age (SGA) may experience more long-term neurodevelopmental issues than those born appropriate for gestational age (AGA). This study aimed to assess differences in the neurodevelopment of children born SGA or AGA within a periurban community in Pakistan.Methods This was a prospective cohort study in which study participants were followed from the pilot Doppler cohort study conducted in 2018. This pilot study aimed to develop a pregnancy risk stratification model using machine learning on fetal Dopplers. This project identified 119 newborns who were born SGA (2.4±0.4 kg) based on International Fetal and Newborn Growth Consortium standards. We assessed 180 children (90 SGA and 90 AGA) between 2 and 4 years of age (76% of follow-up rate) using the Malawi Developmental Assessment Tool (MDAT).Findings Multivariable linear regression analysis comparing the absolute scores of MDAT showed significantly lower fine motor scores (β: −0.98; 95% CI −1.90 to –0.06) among SGAs, whereas comparing the z-scores using multivariable logistic regression, SGA children had three times higher odds of overall z-scores ≤−2 (OR: 3.78; 95% CI 1.20 to 11.89) as compared with AGA children.Interpretation SGA exposure is associated with poor performance on overall MDAT, mainly due to changes in the fine motor domain in young children. The scores on the other domains (gross motor, language and social) were also lower among SGAs; however, none of these reached statistical significance. There is a need to design follow-up studies to assess the impact of SGA on child’s neurodevelopmental trajectory and school performance.Data are available on reasonable request. Data are available on reasonable request by contacting the corresponding author and following acceptance by the contributing institution.