title: Intrauterine growth-restricted neonates born at term or preterm: how different?
abstract: Late onset intrauterine growth restriction is a common form of growth restriction, mainly caused by placenta-vascular insufficiency. Whether the intrauterine or extrauterine environment offers a better long-term outcome for the growth-restricted fetus remains unclear. We compared the risk factors and long-term outcomes of late onset growth-restricted neonates delivered between 31-36 weeks of gestation vs those delivered at term. This prospective cohort study included 114 preterm and 193 term born growth-restricted neonates. They underwent a neurobehavioral examination (neonatal period), a neurodevelopmental assessment and the Bayley Scales of Infant Development (age 2 years), and neuromotor assessment and the Wechsler Preschool and Primary Scale of Intelligence (age 6 years). Growth-restricted neonates born prematurely exhibited a significantly higher incidence of maternal hypertension, a maternal history of abortions and stillbirths, increased intrapartum and postnatal complication rates, and abnormal neonatal neurobehavioral scores than expected. Both preterm and term born growth-restricted groups, however, exhibited comparable long-term neurodevelopmental and cognitive outcomes at ages 2 and 6 years. Although prematurely born neonates undergo an earlier growth restriction process and exhibit a higher perinatal risk factor profile, their long-term outcomes are comparable to those of growth-restricted neonates born at term.
authors.affiliation: Child Neurology and Development Unit, Dana Children's Hospital, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. bassan@post.tau.ac.il
authors.forename: Haim
authors.initials: H
authors.lastname: Bassan
authors.forename: Orit
authors.initials: O
authors.lastname: Stolar
authors.forename: Ronny
authors.initials: R
authors.lastname: Geva
authors.forename: Rina
authors.initials: R
authors.lastname: Eshel
authors.forename: Aviva
authors.initials: A
authors.lastname: Fattal-Valevski
authors.forename: Yael
authors.initials: Y
authors.lastname: Leitner
authors.forename: Maya
authors.initials: M
authors.lastname: Waron
authors.forename: Ariel
authors.initials: A
authors.lastname: Jaffa
authors.forename: Shaul
authors.initials: S
authors.lastname: Harel
mesh_terms: D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology / Q000503:physiopathology* / Q000523:psychology; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000502:physiology* / Q000523:psychology; D008297:Male; D011247:Pregnancy; D012307:Risk Factors