Elsevier

Pediatric Neurology

Volume 26, Issue 3, March 2002, Pages 186-191
Pediatric Neurology

Original article
Neuropsychologic and motor function in small-for-gestation preschoolers

https://doi.org/10.1016/S0887-8994(01)00381-2Get rights and content

Abstract

The aim of this study was to evaluate neuropsychologic and motor performance in term small-for-gestation preschool children. A patient-based sample of 311 5-year-old children with birth weights less than the fifteenth percentile for gestation was compared with a random sample of 321 appropriate-for-gestation control subjects. The main assessment tools were subscales from the Wechsler Preschool and Primary Scale of Intelligence Revised, subscales from the Illinois Test of Psycholinguistic Abilities, tests of manual dexterity and figure copying, and the Peabody Developmental Motor Scales. The small-for-gestation children had mean scores on tests of visuospatial and visuomotor abilities that were one fourth standard deviation lower than appropriate-for-gestation control subjects and slightly lower scores on manual dexterity. The small-for-gestation children were comparable to appropriate-for-gestation children regarding motor performance. We therefore conclude that the neuropsychologic and neuromotor performance in preschool years of term small-for-gestation children is reassuring.

Introduction

Both preterm low-birth-weight and term small-for-gestation children have been reported to have a lower mean intelligence quotient than normal birth weight control subjects, the size of the difference being approximately five points [1], [2]. For preterm low-birth-weight children, visuospatial and visuomotor performance have typically been more affected than verbal proficiency [2]. Such possible differences have rarely been studied in term small-for-gestation children.

Impaired motor performance and increased frequency of minor neurologic dysfunction have been described in nonhandicapped preterm low-birth-weight children [3]. Among term small-for-gestation children, however, previous findings have been inconsistent [4], [5].

The aims of the present study were as follows: (1) to describe the typical pattern of neuropsychologic impairment in preschool small-for-gestation children in a large population-based sample; (2) to investigate whether decreased gross motor and fine motor performance and an increased frequency of minor neurologic dysfunction are observed in small-for-gestation compared with appropriate-for-gestation preschoolers; and (3) to investigate, in explorative analyses, whether identifiable maternal risk factors for giving birth to a small-for-gestation infant are predictive of performance on neuropsychologic and motor measures among small-for-gestation children.

Section snippets

Materials and methods

Follow-up study of infants until 13 months of age and intelligence quotients of children at 5 years of age, including family demographics and socioeconomic and parental factors, have been described in previous studies [2], [6], [7], [8].

This study was part of a large prospective, multicenter study on causes and consequences of in utero growth retardation, the NICHD Study of Successive Small-for-Gestational Age Births (NSSSAB). The basic study design has been described previously [9]. Between

Results

A total of 677 eligible small-for-gestation and appropriate-for-gestation children were examined at 5 years of age. This constituted 68% of the 997 eligible children (Table 1). Parents declining participation was the most common cause of loss to follow-up (Table 1). There were no statistically significant differences within either the small-for-gestation or the appropriate-for-gestation groups between children who were lost to follow-up after birth and those who were assessed regarding

Discussion

The major finding of the present study was that term small-for-gestation preschoolers as a group differed little from their appropriate-for-gestation peers regarding neuropsychologic profile and neuromotor outcome. However, the small-for-gestation children had 0.25 S.D. lower mean scores on items involving visuospatial performance. Among the small-for-gestation children, identifiable maternal risk factors for giving birth to a small-for-gestation infant were not predictive of child outcome at

Acknowledgments

We thank Mrs. Francoise Alsaker for valuable help with selection of appropriate methods for parental evaluation and Mrs. Tone Flornes for valuable help in collecting the data for this project and the rest of the staff at the Department of Biologic and Medical Psychology, University of Bergen. The study has been financed by the Norwegian Research Council (NFR) Grant No: 102697/320, and partly by the Norwegian Red Cross Research Fund and NICHD, NIH project number RFP-NICHD-PRP-90-11. Karin

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