Behavioral outcomes of school-aged full-term small-for-gestational-age infants: A nationwide Japanese population-based study.
BACKGROUND
Small for gestational age (SGA) birth is linked with neurological deficits among children at pre-school age, but the evidence is still limited on whether such deficits are still observable at school age. We investigated the association between SGA birth and behavioral development at school age among full-term infants.


METHODS
We analyzed data from a large, Japanese, nationwide, population-based longitudinal survey that started in 2001. We restricted the study participants to children born at 37-41weeks of gestation with information on birth weight and behavioral outcomes at 8years of age (n=33,795). Behavioral outcomes including three attentional problems and four aggressive behaviors queried at 8years of age by survey questions were used as outcome indicators. We then used logistic regression to estimate odds ratios (OR) and 95% confidence intervals (95% CI) for the associations between SGA birth and each outcome, adjusting for potential infant- and parent-related confounding factors.


RESULTS
Among full-term children, SGA children were more likely to interrupt people (OR 1.10, 95% CI 1.01, 1.20), unable to wait his/her turn (OR 1.17, 95% CI 1.00, 1.38), and destroy toys and/or books (OR 1.15, 95% CI 1.00, 1.31).


CONCLUSIONS
This is the largest study ever conducted on this issue. SGA birth is negatively associated with some attentional problems and aggressive behavior at school age among full-term children. Appropriate long-term developmental follow-up and support may be needed for full-term SGA infants.
Department of Neonatology, Okayama Medical Center, National Hospital Organization, Okayama, Japan. Electronic address: gmd18025@s.okayama-u.ac.jp.
Akihito
A
Takeuchi
Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, Okayama, Japan.
Takashi
T
Yorifuji
Department of Pediatrics, Okayama Medical Center, National Hospital Organization, Okayama, Japan.
Kyohei
K
Takahashi
Department of Neonatology, Okayama Medical Center, National Hospital Organization, Okayama, Japan.
Makoto
M
Nakamura
Department of Neonatology, Okayama Medical Center, National Hospital Organization, Okayama, Japan.
Misao
M
Kageyama
Department of Pediatrics, Okayama Medical Center, National Hospital Organization, Okayama, Japan.
Toshihide
T
Kubo
Department of Children Studies, Faculty of Children Studies, Chugokugakuen University, Okayama, Japan.
Tatsuya
T
Ogino
Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Katsuhiro
K
Kobayashi
Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Hiroyuki
H
Doi
D000374:Aggression; D001288:Attention; D002648:Child; D002652:Child Behavior; D002653:Child Behavior Disorders / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007236:Infant, Small for Gestational Age / Q000523:psychology*; D007564:Japan / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male
Attention; Behavior; Full-term; School age; Small-for-gestational-age