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

ABSTRACT

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.