Cognitive Functioning and Academic Achievement in Children Aged 6-8 Years, Born at Term After Intrauterine Growth Restriction and Fetal Cerebral Redistribution.

OBJECTIVE

To determine whether cerebroplacental ratio, an indicator of fetal cerebral redistribution (FCR), predicts adverse results for neurodevelopment in intrauterine growth restriction (IUGR) infants.

METHODS

In a cohort of 5,702 infants, 64 were IUGR born at term with FCR. Five were excluded. Of the remainder, 32 presented an abnormal cerebroplacental ratio (IUGR-A) and 27 a normal one (IUGR-B). The controls were 61 appropriate-for-gestational-age children. Cognitive and academic outcomes and the odds ratio of lower academic scores were assessed by multivariate analysis of covariance and logistic regression.

RESULTS

IUGR-A children presented deficits in cognitive functioning and academic achievement in all domains. IUGR-B children presented slight deficits. Suboptimal cognitive functioning in IUGR-A was more marked in working memory. Abnormal cerebroplacental ratio predicted low academic scores in IUGR-A.

CONCLUSIONS

FCR is a risk factor for IUGR infants, and cerebroplacental ratio identifies those most severely affected. Intervention programs may produce benefits in early-middle childhood.