title: The influence of fetal growth reference standards on assessment of cognitive and academic outcomes of very preterm children.
abstract: OBJECTIVE
  To compare 3 methods of identifying small-for-gestational-age (SGA) status in very preterm children as related to cognitive function and academic outcome.
  
  
  METHODS
  There were 1038 singletons in the Epipage Study, born before 33 weeks in 1997 without severe neurosensory impairment, who were classified as SGA when birth weight was below the 10th percentile according to: (1) birth weight (bw) reference: SGA(bw)/appropriate for gestational age (AGA)(bw); (2) intrauterine (intraut) reference: SGA(intraut)/AGA(intraut); and (3) intrauterine reference customized (cust) according to individual characteristics: SGA(cust)/AGA(cust). Cognitive function was assessed by the mental processing composite (MPC) score of the Kaufman Assessment Battery for Children at age 5 and academic achievement by a parental questionnaire at age 8.
  
  
  RESULTS
  Of the children, 15% were SGA(bw), 38% were SGA(intraut), and 39% were SGA(cust). All children SGA(bw) were also SGA(intraut) and SGA(cust). MPC was <85 in 32% of children and 27% had low academic achievement. AGA(bw)/SGA(intraut) children had a significantly increased risk of MPC <85 (adjusted OR 1.74, 95% CI 1.22-2.28) or low academic achievement (adjusted OR 1.64, 95% CI 1.05-2.55) compared with AGA(bw)/AGA(intraut) children. The SGA(cust) group was only slightly different from the SGA(intraut) group.
  
  
  CONCLUSIONS
  An intrauterine reference identified very preterm infants at risk of poor cognitive or academic outcomes better than a birth weight reference. Customization resulted in only slight modifications of the SGA group.
authors: INSERM, UMR S953, Epidemiological Research on Perinatal Health and Women's and Children's Health, Hôpital Tenon, Paris, France. charkaluk.marie-laure@ghicl.net
authors: Marie-Laure
authors: ML
authors: Charkaluk
authors: Laetitia
authors: L
authors: Marchand-Martin
authors: Anne
authors: A
authors: Ego
authors: Jennifer
authors: J
authors: Zeitlin
authors: Catherine
authors: C
authors: Arnaud
authors: Antoine
authors: A
authors: Burguet
authors: Stéphane
authors: S
authors: Marret
authors: Jean-Christophe
authors: JC
authors: Rozé
authors: Rachel
authors: R
authors: Vieux
authors: Monique
authors: M
authors: Kaminski
authors: Pierre-Yves
authors: PY
authors: Ancel
authors: Véronique
authors: V
authors: Pierrat
mesh_terms: D000124:Achievement; D001724:Birth Weight; D002648:Child; D002675:Child, Preschool; D003071:Cognition; D005260:Female; D005500:Follow-Up Studies; D057238:Growth Charts; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000523:psychology*; D007236:Infant, Small for Gestational Age / Q000523:psychology*; D008297:Male; D011581:Psychological Tests; D011795:Surveys and Questionnaires