TY - JOUR
T1 - Associations of Birth Weight for Gestational Age with Child Health and Neurodevelopment among Term Infants
T2 - A Nationwide Japanese Population-Based Study
AU - Tamai, Kei
AU - Yorifuji, Takashi
AU - Takeuchi, Akihito
AU - Fukushima, Yu
AU - Nakamura, Makoto
AU - Matsumoto, Naomi
AU - Washio, Yosuke
AU - Kageyama, Misao
AU - Tsukahara, Hirokazu
N1 - Publisher Copyright:
© 2020 Elsevier Inc.
PY - 2020/11
Y1 - 2020/11
N2 - Objective: To examine the association of specific Z-score categories of birth weight for gestational age with child health and neurodevelopment using a large nationwide survey in Japan, focusing on term infants. Study design: We included 36 321 children born in 2010. Hospitalization up to 66 months of age was used as an indicator of health status, and responses to questions about age-appropriate behaviors at 30 and 66 months of age were used to indicate neurobehavioral development. We conducted binomial log-linear regression analyses, controlling for child and parental variables. A restricted cubic spline function was used to model the relationship. Results: Compared with children with birth weight appropriate for gestational age (−1.28 to 1.28 SDs of expected birthweight for gestational age), children who were small for gestational age (SGA) (<−1.28 SD) had higher risks of hospitalization and unfavorable neurobehavioral development, and the risks increased as SGA status became more severe. Compared with the appropriate for gestational age group, the adjusted risk ratios for hospitalization for all causes were 2.5 (95% CI, 1.7-3.6), 1.3 (95% CI, 1.1-1.6), and 1.1 (95% CI, 1.0-1.2) for children who were severely, moderately, and mildly SGA and 1.0 (95% CI, 0.9-1.1), 1.1 (95% CI, 0.9-1.2), and 1.4 (95% CI, 0.9-2.1) for children who were mildly, moderately, and severely large for gestational age, respectively. Severely large for gestational age children also had higher risks of unfavorable neurobehavioral development. These results were supported by spline analyses. Conclusions: Among term infants, the risks of unfavorable child health and neurodevelopment increased with the severity of SGA.
AB - Objective: To examine the association of specific Z-score categories of birth weight for gestational age with child health and neurodevelopment using a large nationwide survey in Japan, focusing on term infants. Study design: We included 36 321 children born in 2010. Hospitalization up to 66 months of age was used as an indicator of health status, and responses to questions about age-appropriate behaviors at 30 and 66 months of age were used to indicate neurobehavioral development. We conducted binomial log-linear regression analyses, controlling for child and parental variables. A restricted cubic spline function was used to model the relationship. Results: Compared with children with birth weight appropriate for gestational age (−1.28 to 1.28 SDs of expected birthweight for gestational age), children who were small for gestational age (SGA) (<−1.28 SD) had higher risks of hospitalization and unfavorable neurobehavioral development, and the risks increased as SGA status became more severe. Compared with the appropriate for gestational age group, the adjusted risk ratios for hospitalization for all causes were 2.5 (95% CI, 1.7-3.6), 1.3 (95% CI, 1.1-1.6), and 1.1 (95% CI, 1.0-1.2) for children who were severely, moderately, and mildly SGA and 1.0 (95% CI, 0.9-1.1), 1.1 (95% CI, 0.9-1.2), and 1.4 (95% CI, 0.9-2.1) for children who were mildly, moderately, and severely large for gestational age, respectively. Severely large for gestational age children also had higher risks of unfavorable neurobehavioral development. These results were supported by spline analyses. Conclusions: Among term infants, the risks of unfavorable child health and neurodevelopment increased with the severity of SGA.
KW - behavioral development
KW - hospitalization
KW - large for gestational age
KW - small for gestational age
KW - term birth
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U2 - 10.1016/j.jpeds.2020.06.075
DO - 10.1016/j.jpeds.2020.06.075
M3 - Article
C2 - 32640270
AN - SCOPUS:85089445140
VL - 226
SP - 135-141.e4
JO - Journal of Pediatrics
JF - Journal of Pediatrics
SN - 0022-3476
ER -