title: Neurodevelopment in full-term small for gestational age infants: A nationwide Japanese population-based study.
abstract: OBJECTIVE
  To investigate neurological development in small for gestational age (SGA) infants, with a focus on full-term SGA infants.
  
  
  METHODS
  We analyzed data from a large, Japanese, nationwide, population-based longitudinal survey started in 2001. We restricted the study to participants born before 42weeks of gestation (n=46,563). Parents were asked questions about motor and language development when the children were 2.5years old, and about behavioral development at 5.5years. We analyzed the relationships between SGA status and development by logistic regression. Odds ratios (ORs) and 95% confidence intervals (95% CI) were calculated for each outcome for full-term and preterm births, adjusting for potential infant- and parent-related confounding factors. We also calculated the population-attributable fractions to estimate the public impact of SGA births.
  
  
  RESULTS
  SGA full-term children were more likely to demonstrate developmental delays at 2.5years, e.g., being unable to walk alone (OR 3.0, 95% CI: 1.7, 5.3), compose a two-phrase sentence (OR 1.5, 95% CI: 1.2, 1.8), or use a spoon to eat (OR 1.5, 95% CI: 1.1, 1.9). SGA status also had some degree of negative impacts on behavioral problems at 5.5years among term children, e.g., being unable to listen without fidgeting (OR 1.2, 95% CI: 1.1, 1.3), or remain patient (OR 1.1, 95% CI: 1.0, 1.2). The public health impacts were comparable between full-term and preterm SGA children at 2.5years.
  
  
  CONCLUSIONS
  SGA is a risk factor for developmental delay, even in full-term infants, with non-negligible public health impacts.
authors.affiliation: Department of Neonatology, Okayama Medical Center, National Hospital Organization, Okayama, Japan. Electronic address: gmd18025@s.okayama-u.ac.jp.
authors.forename: Akihito
authors.initials: A
authors.lastname: Takeuchi
authors.affiliation: Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, Okayama, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yorifuji
authors.affiliation: Department of Pediatrics, Okayama Medical Center, National Hospital Organization, Okayama, Japan.
authors.forename: Kyohei
authors.initials: K
authors.lastname: Takahashi
authors.affiliation: Department of Neonatology, Okayama Medical Center, National Hospital Organization, Okayama, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: Department of Neonatology, Okayama Medical Center, National Hospital Organization, Okayama, Japan.
authors.forename: Misao
authors.initials: M
authors.lastname: Kageyama
authors.affiliation: Department of Pediatrics, Okayama Medical Center, National Hospital Organization, Okayama, Japan.
authors.forename: Toshihide
authors.initials: T
authors.lastname: Kubo
authors.affiliation: Department of Children Studies, Faculty of Children Studies, Chugokugakuen University, Okayama, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Ogino
authors.affiliation: Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Doi
mesh_terms: D002675:Child, Preschool; D002658:Developmental Disabilities / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007236:Infant, Small for Gestational Age / Q000254:growth & development*; D007564:Japan / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors
keywords: Behavior; Development; Epidemiology; Growth; Small-for-gestational-age