Catch-Up Growth and Neurobehavioral Development among Full-Term, Small-for-Gestational-Age Children: A Nationwide Japanese Population-Based Study - 07/11/17

Doi : 10.1016/j.jpeds.2017.09.002

Akihito Takeuchi, MD, PhD ^1,^* , Takashi Yorifuji, MD, PhD ², Kazue Nakamura, MD ¹, Kei Tamai, MD ¹, Shigehiro Mori, MD ¹, Makoto Nakamura, MD, PhD ¹, Misao Kageyama, MD ¹, Toshihide Kubo, MD, PhD ³, Tatsuya Ogino, MD ⁴, Katsuhiro Kobayashi, MD, PhD ⁵, Hiroyuki Doi, MD, PhD ⁶
¹ Department of Neonatology, Okayama Medical Center, National Hospital Organization, Okayama, Japan
² Department of Human Ecology, Okayama University Graduate School of Environmental and Life Science, Okayama, Japan
³ Department of Pediatrics, Okayama Medical Center, National Hospital Organization, Okayama, Japan
⁴ Department of Children Studies, Faculty of Children Studies, Chugokugakuen University, Okayama, Japan
⁵ Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
⁶ Department of Epidemiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan

^*Reprint requests: Akihito Takeuchi, MD, PhD, Department of Neonatology, Okayama Medical Center, National Hospital Organization, 1711-1 Tamasu, Kita-ku, Okayama 701-1192, Japan.Department of NeonatologyOkayama Medical CenterNational Hospital Organization1711-1 TamasuKita-kuOkayama701-1192Japan

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Abstract

Objective

To examine the relationship between catch-up growth of full-term, small for gestational age (SGA) children and their neurobehavioral development.

Study design

Data were obtained from a population-based nationwide Japanese longitudinal survey that started in 2001. Study participants were full-term children with information on height at 2 years of age (n = 32 533). Catch-up growth for SGA infants was defined as achieving a height at 2 years of age of more than -2.0 standard deviations for chronological age. Logistic regression analyses were used to estimate ORs and 95% CIs for the associations of SGA and catch-up growth status with neurobehavioral development at 2.5 and 8 years of age, adjusting for potential infant- and parent-related confounding factors.

Results

Fifteen percent of term SGA infants failed to catch up in height. At 2.5 years of age, SGA children without catch-up growth were more likely to be unable to climb stairs (OR, 10.42; 95% CI, 5.55-19.56) and unable to compose a 2-word sentence (OR, 3.58; 95% CI, 1.81-7.08) compared with children with normal growth at birth. Furthermore, SGA children without catch-up growth were at increased risk for aggressive behaviors (OR, 3.85; 95% CI, 1.19-12.47) at 8 years of age.

Conclusions

Continuous follow-up for full-term SGA infants with failure of catch-up growth or poor postnatal growth may be beneficial for early detection and intervention for behavioral problems.

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Keywords : postnatal growth, aggressive behavior, attention, motor development, language development, personal–social development

Abbreviations : AGA, GA, SGA