Neuropsychologic development of small for gestational age preterm infants: follow up at 12-36 months of age

We followed 94 preterm infants (G.A. < 37 weeks) small for gestational age (SGA) born from 1980 to 1987 in Pavia and admitted to the Neonatal Intensive Care Unit of S. Matteo Hospital (Pavia). A control group matched for gestational age of 94 preterm appropriate for gestational age (AGA) was also studied. Neurological examination was carried out at 40 weeks postmenstrual age and at 3, 6, 9, 12, 24, 36 months of age with the method of Amiel-Tison and Grenier (1986). Psychomotor development was assessed using Brunet-Lezine's Scale until 1985 and after Bayley Scales of Infant Development. Intrauterine mortality was 23.40% in the SGA group and 5.32% in the AGA group (p = 0.0003); neonatal mortality was 18% in the SGA group and 6.62% in the AGA group (p < 0.01). 42 SGA (80.8%) and 58 AGA (79.5%) were completely normal (group A) at 36 months, but SGA infants showed transient neurological abnormalities (TNA) more frequently than the control group (30.7% vs 6.8% - p < 0.001). 5 SGA (9.6%) and 10 AGA (13.7%) had minor abnormalities (group B); no SGA children and only one AGA had diplegia (group C); 3 SGA (5.8%) and 4 AGA (5.5%) were considered to have severe handicap (group D) SGA children had a higher incidence of epilepsy (3.8% vs 0) than AGA (group E). These results show that in our group of SGA preterm infants the union of intrauterine growth retardation and prematurity compromise the possibility of survival