Small-for-gestational-age and suspected developmental coordination disorder in preschool children:A national cross-sectional study highlighting vulnerability in full-term births.

OBJECTIVE

Small-for-gestational-age (SGA) birth has been associated with adverse neurodevelopmental outcomes. However, its relationship with suspected developmental coordination disorder (DCD) in preschool children remains unclear. We therefore examined whether SGA was independently associated with suspected DCD risk in a national population-based sample.

STUDY

DESIGN

We analyzed CNCMD data from 101,505 preschool children aged 3-5 years. Birthweight-for-gestational-age status was classified using national sex- and gestational-age-specific standards, and suspected DCD was assessed using the Chinese version of the Little Developmental Coordination Disorder Questionnaire (LDCDQ-CH). Multivariable models adjusted for child, family, and maternal characteristics, with subgroup analyses evaluating potential effect modification.

RESULTS

Among 101 505 children, 9 222 (9.1%) were SGA and 7 531 (7.4%) had DCD. SGA was associated with lower LDCDQ-CH scores (β = -0.50, 95% CI -0.69 to -0.32; p < 0.001) and higher odds of DCD (OR 1.11, 95% CI 1.03-1.21; p = 0.008). Associations of SGA with DCD were similar across sex, exclusive breastfeeding, and maternal-education, but were strongest among full-term births (OR 1.28, 95% CI 1.15-1.43; p interaction = 0.003). Adjusted risks were 7.35% (95% CI 7.14-7.56) in AGA and 8.11% (7.55-8.67) in SGA, corresponding to an adjusted RD of +0.76 percentage points (0.19-1.33). This translates to 7.6 additional cases per 1000 children. Sensitivity analyses confirmed robustness.

CONCLUSION

SGA was associated with suspected DCD, with the association most evident among children born at full term. These findings extend understanding of early-life factors associated with preschool motor development beyond prematurity alone.