title: Etiological Subgroups of Small-for-Gestational-Age: Differential Neurodevelopmental Outcomes.
abstract: OBJECTIVE
  It remains unclear why substantial variations in neurodevelopmental outcomes exist within small-for-gestational-age (SGA) children. We prospectively compared 5-y neurodevelopmental outcomes across SGA etiological subgroups.
  
  
  METHODS
  Children born SGA (N = 1050) from U.S. Early Childhood Longitudinal Study-Birth Cohort (2001-2007) was divided into etiological subgroups by each of 7 well-established prenatal risk factors. We fit linear regression models to compare 5-y reading, math, gross motor and fine motor scores across SGA subgroups, adjusting for socio-demographic confounders.
  
  
  RESULTS
  Compared to singleton SGA subgroup, multiple-birth SGA subgroup had lower mean reading (adjusted mean difference, -4.08 [95% confidence interval, -6.10, -2.06]) and math (-2.22 [-3.61, -0.84]) scores. These disadvantages in reading and math existed only among multiple-birth SGA subgroup without ovulation stimulation (reading, -4.50 [-6.64, -2.36]; math, -2.91 [-4.37, -1.44]), but not among those with ovulation stimulation (reading, -2.33 [-6.24, 1.57]; math 0.63 [-1.86, 3.12]). Compared to singleton SGA subgroup without maternal smoking and inadequate gestational weight gain, singleton SGA subgroup with co-occurrence of maternal smoking and inadequate gestational weight gain (GWG) had lower mean reading (-4.81 [-8.50, -1.12]) and math (-2.95 [-5.51, -0.38]) scores. These differences were not mediated by Apgar score.
  
  
  CONCLUSIONS
  Multiple-birth SGA subgroups (vs. singleton SGA) or singleton SGA subgroup with co-occurrence of smoking and inadequate GWG (vs. singleton SGA subgroup without maternal smoking and inadequate gestational weight gain) have poorer cognitive development up to 5 y.
authors: Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, China.|Division of Behavioral Medicine, Department of Pediatrics, University at Buffalo, State University of New York, Buffalo, NY, 14214, United States of America.
authors: Xiuhong
authors: X
authors: Li
authors: Research Institute on Addictions, University at Buffalo, State University of New York, Buffalo, NY, 14203, United States of America.
authors: Rina D
authors: RD
authors: Eiden
authors: Division of Behavioral Medicine, Department of Pediatrics, University at Buffalo, State University of New York, Buffalo, NY, 14214, United States of America.
authors: Leonard H
authors: LH
authors: Epstein
authors: Maternal and Child Health Program, School of Public Health, University of Maryland, College Park, MD, 20742, United States of America.|Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MD, 20742, United States of America.|Department of Epidemiology, School of Public Health, Brown University, Providence, RI, 02912, United States of America.
authors: Edmond D
authors: ED
authors: Shenassa
authors: Division of Behavioral Medicine, Department of Pediatrics, University at Buffalo, State University of New York, Buffalo, NY, 14214, United States of America.|Department of Cancer Prevention Research, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province 510060, China.
authors: Chuanbo
authors: C
authors: Xie
authors: Division of Behavioral Medicine, Department of Pediatrics, University at Buffalo, State University of New York, Buffalo, NY, 14214, United States of America.
authors: Xiaozhong
authors: X
authors: Wen
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D005865:Gestational Age; D006801:Humans; D006973:Hypertension / Q000150:complications*; D007223:Infant; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000254:growth & development*; D008137:Longitudinal Studies; D008297:Male; D065886:Neurodevelopmental Disorders / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D011247:Pregnancy; D011272:Pregnancy, Multiple; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D015430:Weight Gain