title: Early childhood neurodevelopment after intrauterine growth restriction: a systematic review.
abstract: OBJECTIVE
  Children who experienced intrauterine growth restriction (IUGR) may be at increased risk for adverse developmental outcomes in early childhood. The objective of this study was to carry out a systematic review of neurodevelopmental outcomes from 6 months to 3 years after IUGR.
  
  
  METHODS
  PubMed, Embase, PsycINFO, Maternity and Infant Care, and CINAHL databases were searched by using the search terms intrauterine, fetal, growth restriction, child development, neurodevelopment, early childhood, cognitive, motor, speech, language. Studies were eligible for inclusion if participants met specified criteria for growth restriction, follow-up was conducted within 6 months to 3 years, methods were adequately described, non-IUGR comparison groups were included, and full English text of the article was available. A specifically designed data extraction form was used. The methodological quality of included studies was assessed using well-documented quality-appraisal guidelines.
  
  
  RESULTS
  Of 731 studies reviewed, 16 were included. Poorer neurodevelopmental outcomes after IUGR were described in 11. Ten found motor, 8 cognitive, and 7 language delays. Other delays included social development, attention, and adaptive behavior. Only 8 included abnormal Doppler parameters in their definitions of IUGR.
  
  
  CONCLUSIONS
  Evidence suggests that children are at risk for poorer neurodevelopmental outcomes following IUGR from 6 months to 3 years of age. The heterogeneity of primary outcomes, assessment measures, adjustment for confounding variables, and definitions of IUGR limits synthesis and interpretation. Sample sizes in most studies were small, and some examined preterm IUGR children without including term IUGR or AGA comparison groups, limiting the value of extant studies.
authors.affiliation: School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland; f.a.alderdice@qub.ac.uk.
authors.forename: Terri A
authors.initials: TA
authors.lastname: Levine
authors.affiliation: School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland; Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada; Child and Family Research Institute, Vancouver, Canada;
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Grunau
authors.affiliation: Department of Obstetrics and Gynaecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Dublin, Ireland;
authors.forename: Fionnuala M
authors.initials: FM
authors.lastname: McAuliffe
authors.affiliation: Department of Neonatology, Rotunda Hospital, Dublin, Ireland; and Children's University Hospital, Temple Street, Dublin, Ireland.
authors.forename: RagaMallika
authors.initials: R
authors.lastname: Pinnamaneni
authors.affiliation: Department of Neonatology, Rotunda Hospital, Dublin, Ireland; and Children's University Hospital, Temple Street, Dublin, Ireland.
authors.forename: Adrienne
authors.initials: A
authors.lastname: Foran
authors.affiliation: School of Nursing and Midwifery, Queen's University Belfast, Belfast, Northern Ireland;
authors.forename: Fiona A
authors.initials: FA
authors.lastname: Alderdice
mesh_terms: D002675:Child, Preschool; D002658:Developmental Disabilities / Q000209:etiology*; D005317:Fetal Growth Retardation; D006801:Humans; D007223:Infant; D009420:Nervous System / Q000254:growth & development*
keywords: cognition; developmental outcomes; early childhood; growth; intrauterine growth restriction; neurodevelopment