title: Axonal loss and cognitive deficits in term infants with normal umbilical artery Doppler born small-for-gestational age.
abstract: OBJECTIVE
  To assess cognitive outcomes and structural changes in the central nervous system, the latter using a novel approach to examine changes in neuronal integrity of the optic nerve, in children at 5-6½ years of age who were born small-for-gestational age (SGA) at term having shown normal umbilical artery (UA) Doppler.
  
  
  METHODS
  We compared neuronal damage, cognitive deficits and visuospatial perception in two cohorts of infants, one born SGA (n = 40) and one born appropriate-for-gestational age (AGA) (n = 39) in weight. Neuronal damage was evaluated using optical coherence tomography (OCT) of the optic nerve. Cognitive deficits were assessed with the Wechsler Preschool and Primary Scale of Intelligence (WPPSI) test. Visuospatial perception was evaluated with Rey-Osterreich Complex Figure (ROCF) tasks.
  
  
  RESULTS
  Children from the SGA group had a significantly thinner average retinal nerve fiber layer (RNFL) compared with those from the AGA group (98.2 vs 104.5 µm, P = 0.012). Children from the SGA group exhibited impaired performance in copy tasks on the ROCF (3.27 vs 3.56, P = 0.036) and a higher rate of suboptimal WPPSI test performance intelligence quotient scores (15% vs 0%; P = 0.025) compared with those from the AGA group.
  
  
  CONCLUSIONS
  Term infants with normal UA Doppler born SGA are at increased risk for cognitive deficits and axonal loss in the RNFL at the age of 5-6½ years.
authors: Ophthalmology Department, Hospital Universitario Miguel Servet, Zaragoza, Spain. vpueyo@unizar.es
authors: V
authors: V
authors: Pueyo
authors: D
authors: D
authors: Oros
authors: S
authors: S
authors: Valle
authors: H
authors: H
authors: Tuquet
authors: N
authors: N
authors: Güerri
authors: M
authors: M
authors: Argüelles
authors: P
authors: P
authors: Ventura
mesh_terms: D000328:Adult; D001369:Axons / Q000473:pathology*; D002490:Central Nervous System / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D009900:Optic Nerve / Q000503:physiopathology*; D010465:Perception; D041623:Tomography, Optical Coherence / Q000379:methods*; D018608:Ultrasonography, Doppler / Q000379:methods*; D016216:Ultrasonography, Prenatal; D014469:Umbilical Arteries / Q000000981:diagnostic imaging*