Gebelik Haftasına Göre Simetrik ve Asimetrik Büyüme Geriliği Olan Geç Prematüre Bebeklerin Nörogelişimsel Sonuçlarının Karşılaştırılması

Abstract

Aim: Small for gestational age newborns face many risks after birth. These babies may also have neurobehavioral abnormalities. These infants tend to have poor growth and neurodevelopmental outcome when they reach the school age and adulthood. Symmetrical SGA babies have lesser number of cells and small cell size. On the other hand, those who are asymmetric are more likely to catch up because of the normal number of cells. We aimed to assess the language, motor, cognitive skills and general development and factors affecting the neurodevelopmental prognosis in symmetrical and asymmetrical SGA infants using the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III).

Material and methods: The study was carried out in Hacettepe University Faculty of Medicine, Department of Pediatrics,,Division of Neonatology and Division of Developmental Pediatrics between January 2018 and June 2018. We recruited infants from the birth registry records born between January 2015 and November 2017, at 340/7 to 366/7 gestational weeks whose birth weight is less than the 10th percentile for gestational age, discharged with mother or from the neonatal intensive care unit. These babies were seperated into two groups as symmetric SGA (both the birth weigth and head circumference below the 10th percentile) and asymmetric (only weight below the 10th percentile) SGA. A total of 30 patients 14 in symmetrical and 16 in asymmetrical SGA groups were included to the study. Bayley-III was applied to all the cases in order to assess their psychomotor development levels. Results: Median Bayley-III composite scores in the language (p:0,044) and motor (0,031) domains were significantly higher in asymmetrical SGA infants. In the cognitive domain no significant difference was found between the two groups (p:0,0127). Expressive language scores were significantly lower in symmetrical SGA infants (0,008). Fine motor scores were significantly lower in symmetrical SGA infants (0,004).

Conclusion: In this study, we found that symmetrical SGA infants have worse neurodevelopmental outcomes than asymmetrical SGA infants. The number of subject in this study is very limited. We therefore think that multicenter studies with larger groups should be carried out to determine prognosis in symmetrical and asymmetrical SGA infants and the factors affecting the prognosis in this way, it will be possible to recognize the high risk group in the early period and to intervene in the earlier period.