Fetal Growth Trajectories Among Small for Gestational Age Babies and Child Neurodevelopment.
Fetal Growth Trajectories Among Small for Gestational Age Babies and Child Neurodevelopment.
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小于胎龄儿的胎儿生长轨迹与儿童神经发育
DOI：
10.1097/ede.0000000000001387
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发表时间：
2021-09-01
期刊：
影响因子：
--
通讯作者：
Jaddoe VWV
中科院分区：
文献类型：
--
作者：
Ferguson KK;Sammallahti S;Rosen E;van den Dries M;Pronk A;Spaan S;Guxens M;Tiemeier H;Gaillard R;Jaddoe VWV
出生时小于胎龄(SGA，<；10%)是神经发育结果较差的风险因素。然而，这一群体是健康和生长受限婴儿的不同组合，并不是所有人都会经历糟糕的结局。我们试图确定胎儿生长轨迹是否可以区分出生于SGA的婴儿中谁的童年神经发育结果最差。目前的分析是在R世代进行的，这是荷兰鹿特丹的一个以人口为基础的队列(N=5487)。使用基于群体的轨迹建模，我们确定了出生于SGA的婴儿体重的胎儿生长轨迹。这些数据是基于怀孕中后期超声测量的标准差分数，并结合出生体重得出的。我们比较了每个生长轨迹中的SGA婴儿和出生时非SGA婴儿在6岁时的儿童非语言智商和注意缺陷多动障碍(ADHD)症状。在SGA个体(n=656)中，我们确定了三种不同的胎儿体重增长轨迹。从孕中期开始持续矮小的儿童(n=)智商最低(比非胎龄儿低7分，95%CI=−11.0，−3.5)，多动症症状略多。出生时较大但较小的出生轨迹的儿童与出生时非SGA的儿童相比，结果没有差异。在SGA儿童中，那些在怀孕中期开始较小的儿童在6岁时表现出最差的神经发育结果。胎儿生长轨迹可能有助于识别后来神经发育结果较差的SGA婴儿。
Being born small for gestational age (SGA, <10th percentile) is a risk factor for worse neurodevelopmental outcomes. However, this group is a heterogeneous mix of healthy and growth-restricted babies, and not all will experience poor outcomes. We sought to determine whether fetal growth trajectories can distinguish who will have the worst neurodevelopmental outcomes in childhood among babies born SGA. The present analysis was conducted in Generation R, a population-based cohort in Rotterdam, the Netherlands (N=5487). Using group-based trajectory modeling, we identified fetal growth trajectories for weight among babies born SGA. These were based on standard deviation scores of ultrasound measures from mid- and late pregnancy in combination with birth weight. We compared child non-verbal IQ and attention deficit hyperactivity disorder (ADHD) symptoms at age 6 between SGA babies within each growth trajectory to babies born non-SGA. Among SGA individuals (n=656), we identified three distinct fetal growth trajectories for weight. Children who were consistently small from mid-pregnancy (n=64) had the lowest IQ (7 points lower compared to non-SGA babies, 95% CI=−11.0, −3.5) and slightly more ADHD symptoms. Children from the trajectory that started off larger but were smaller at birth showed no differences in outcomes compared to children born non-SGA. Among SGA children, those who were smaller beginning in mid-pregnancy exhibited the worst neurodevelopmental outcomes at age 6. Fetal growth trajectories may help identify SGA babies who go on to have poor neurodevelopmental outcomes.
影响因子：
7.7
作者：
Norris T;Johnson W;Petherick E;Cameron N;Oddie S;Johnson S;Wright J;Draper E;Baker PN
通讯作者：
Baker PN