ABSTRACT
In this investigation of 45 children born to mothers with hypertension in pregnancy, our objective was to examine the role of a fetal risk factor (suboptimal intrauterine growth [SOIUG]) in determining developmental outcome. There were two groups of children: Group 1 (n=26; 10 males, 16 females; mean testing age 56.77 mo [SD 13.03], range 41-82 mo; mean gestational age 32.96 wks [SD 2.24], range 27-38 wks; mean birthweight 1,984.42g [SD 563], range 1,046-3,515g) without, and Group 2 (n=19; 6 males, 13 females; mean testing age 57.63 mo [SD 14.86], range 40-84 mo; mean gestational age 34.21 wks [SD 2.10], range 29-39 wks, mean birthweight 1,572g [SD 365], range 855-2,690g) with SOIUG. We found that SOIUG was associated with a significant reduction in cognitive and motor skills (p<0.05). Visuospatial (p<0.01) as well as motor skills (p<0.001) were linearly associated with the extent of intrauterine growth deficit when the latter was treated as a continuous variable. To conclude, an increase in intrauterine growth deficit is accompanied by a proportionate decline in quality of developmental outcome in children born to mothers with hypertension in pregnancy.
Subject(s)
Developmental Disabilities/epidemiology , Fetal Growth Retardation/epidemiology , Hypertension, Pregnancy-Induced/epidemiology , Hypertension, Pregnancy-Induced/physiopathology , Pregnancy Complications/epidemiology , Adult , Child, Preschool , Developmental Disabilities/diagnosis , Female , Humans , Male , PregnancyABSTRACT
The cognitive and language performance of a group of 26 preterm-birth preschool and early school-age children with slight to moderate risk for perinatal hypoxia was compared with the performance of a preterm-birth comparison group of 26 children. Despite the relatively small discrepancy in degree of risk, the cognitive performance of the 2 groups diverged significantly. When data for children with known perinatal arterial pH were combined, a curvilinear (quadratic) regression model provided the best fit. Increasing acidosis was linearly related to decreases in cognitive skills, with the bend in the curve occurring well within the normal range of pH values. Hence, in the preterm infant, even minor risk for birth hypoxia may result in discernible deviation from the expected developmental trajectory.
