title: Differential effect of intrauterine growth restriction on childhood neurodevelopment: a systematic review.
abstract: BACKGROUND
  Neurodevelopmental disorders are increasingly believed to originate from intrauterine growth restriction (IUGR). Current reviews exploring the neurodevelopmental effects of IUGR, however, are mostly based on birthweight, an inadequate proxy.
  
  
  OBJECTIVE
  We aimed to examine the association between IUGR documented in utero, and neurodevelopmental outcomes during childhood.
  
  
  METHODS
  Medline, CINAHL, PsycInfo and Scopus were searched for relevant studies published after 1970.
  
  
  METHODS
  The analysis included studies that identified IUGR in utero, with follow-up assessments between 1 month and 12 years of age.
  
  
  METHODS
  Data was extracted for cognitive, behavioural, language, motor, hearing, vision or sleep outcomes. Studies were summarised separately for children born at <35 and ≥35 weeks gestation.
  
  
  RESULTS
  Of 28 876 titles identified, 38 were suitable for inclusion. IUGR children born ≥35 weeks gestation scored on average 0.5 SD lower than non-IUGR children across all neurodevelopmental assessments. IUGR children born <35 weeks of gestation scored approximately 0.7 SD lower than non-IUGR children across all neurodevelopmental assessments. IUGR children with evidence of fetal circulatory redistribution (preferential perfusion of the brain) had more severe neurodevelopmental impairments than those born IUGR alone.
  
  
  CONCLUSIONS
  IUGR increases the risk of neurodevelopmental impairment during childhood differentially across domains. IUGR children born preterm or with evidence of fetal circulatory redistribution are more severely affected.
  
  
  CONCLUSIONS
  IUGR is associated with an overall risk for neurodevelopmental delay in a range of neurodevelopmental domains.
authors.affiliation: Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK.
authors.forename: E
authors.initials: E
authors.lastname: Murray
authors.affiliation: Nuffield Department of Obstetrics & Gynaecology, Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK.
authors.forename: M
authors.initials: M
authors.lastname: Fernandes
authors.affiliation: Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK.
authors.forename: M
authors.initials: M
authors.lastname: Fazel
authors.affiliation: Nuffield Department of Obstetrics & Gynaecology, Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK.
authors.forename: S H
authors.initials: SH
authors.lastname: Kennedy
authors.affiliation: Nuffield Department of Obstetrics & Gynaecology, Oxford Maternal & Perinatal Health Institute, Green Templeton College, University of Oxford, Oxford, UK.
authors.forename: J
authors.initials: J
authors.lastname: Villar
authors.affiliation: Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, UK.
authors.forename: A
authors.initials: A
authors.lastname: Stein
mesh_terms: D002648:Child; D002653:Child Behavior Disorders / Q000453:epidemiology; D002675:Child, Preschool; D003072:Cognition Disorders / Q000453:epidemiology; D002658:Developmental Disabilities / Q000453:epidemiology*; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology*; D005865:Gestational Age; D006311:Hearing Disorders / Q000453:epidemiology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007806:Language Disorders / Q000453:epidemiology; D019957:Motor Skills Disorders / Q000453:epidemiology; D011247:Pregnancy; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000453:epidemiology; D014786:Vision Disorders / Q000453:epidemiology
keywords: Doppler velocimetry; fetal growth retardation; intrauterine growth restriction; neurodevelopment; serial ultrasound biometry; small-for-gestational-age