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Six-Year Follow-Up of Children With Intrauterine Growth Retardation: Long-Term, Prospective Study

Institute for Child Development and Pediatric Neurology Unit, Division of Pediatrics, Tel Aviv University, Tel Aviv, Israel

Aviva Fattal-Valevski, MD

Institute for Child Development and Pediatric Neurology Unit, Division of Pediatrics, Tel Aviv University, Tel Aviv, Israel

Ronny Geva, PhD

Institute for Child Development and Pediatric Neurology Unit, Division of Pediatrics, Tel Aviv University, Tel Aviv, Israel

Haim Bassan, MD

Institute for Child Development and Pediatric Neurology Unit, Division of Pediatrics, Tel Aviv University, Tel Aviv, Israel

Edith Posner, MD

Institute for Child Development and Pediatric Neurology Unit, Division of Pediatrics, Tel Aviv University, Tel Aviv, Israel

Miriam Kutai, MD

Institute for Child Development and Pediatric Neurology Unit, Division of Pediatrics, Tel Aviv University, Tel Aviv, Israel

Ariel Many, MD

Department of Obstetrics and Gynecology Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Ariel J. Jaffa, MD

Department of Obstetrics and Gynecology Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Shaul Harel, MD

Institute for Child Development and Pediatric Neurology Unit, Division of Pediatrics, Tel Aviv University, Tel Aviv, Israel, child{at}netvision.net.il

This prospective study was designed to characterize the neurodevelopmental and cognitive difficulties specific to children with intrauterine growth retardation and to detect early clinical predictors of these difficulties. Eighty-one children with intrauterine growth retardation were monitored up to 6 to 7 years of age using biometric parameters, perinatal risk questionnaires, and detailed neurodevelopmental and cognitive assessments. Forty-one children served as age-matched, appropriate for gestational age controls. A significant difference in growth parameters (P < .001), neurodevelopmental score (P < .05), and IQ (P < .05) was found between the children with intrauterine growth retardation and controls. A specific profile of difficulties in coordination, lateralization, spatial and graphomotor skills, and abundance of associated movements is typical of the children with intrauterine growth retardation and hints at possible later learning disabilities. The clinical parameters best predicting neurodevelopmental outcome were the neonatal risk score (P < .05) and the weight and height at 6 years of age (P < .05). The children with intrauterine growth retardation with neonatal complications had lower neurodevelopmental scores than the controls but no difference in IQ. Intrauterine growth retardation children diagnosed prenatally had the same neurodevelopmental and IQ scores as those diagnosed at birth, probably due to the careful perinatal and obstetric care provided. Children with intrauterine growth retardation demonstrate a specific profile of neurodevelopmental disabilities at preschool age. Early diagnosis and intervention could probably reduce these difficulties to a minimum. (J Child Neurol 2000;15:781-786).

Journal of Child Neurology, Vol. 15, No. 12, 781-786 (2000)
DOI: 10.1177/088307380001501202


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