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Am J Perinatol 2024; 41(S 01): e1313-e1323
DOI: 10.1055/s-0043-1761920
Original Article

The Association between Infant Birth Weight, Head Circumference, and Neurodevelopmental Outcomes

Maged M. Costantine 
1   Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio
,
Alan T. N. Tita
2   University of Alabama at Birmingham, Birmingham, Alabama
,
Lisa Mele
3   George Washington University Biostatistics Center, Washington, District of Columbia
,
Brian M. Casey
4   University of Texas – Southwestern, Dallas, Texas
,
Alan M. Peaceman
5   Northwestern University, Chicago, Illinois
,
Michael W. Varner 
6   University of Utah Health Sciences Center, Salt Lake City, Utah
,
Uma M. Reddy
7   Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland
,
Ronald J. Wapner
8   Columbia University, New York, New York
,
John M. Thorp Jr.
9   University of North Carolina, Chapel Hill, North Carolina
,
George R. Saade
10   University of Texas Medical Branch, Galveston, Texas
,
Dwight J. Rouse
11   Brown University, Providence, Rhode Island
,
Baha Sibai
12   University of Texas – Houston, Houston, Texas
,
Brian M. Mercer
13   Case Western Reserve University, Cleveland, Ohio
,
Steve N. Caritis
14   University of Pittsburgh, Pittsburgh, Pennsylvania
,
for the Eunice Kennedy Shriver National Institute of Child Health Human Development Maternal-Fetal Medicine Units Network Bethesda MD› Author Affiliations
FundingSupported by grants (HD34116, HD40512, HD27917, HD34208, HD40485, HD40560, HD53097, HD27869, HD40500, HD40545, HD27915, HD40544, HD53118, HD21410, and HD36801) from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Neurological Disorders and Stroke. The views expressed in this article are those of the authors and do not necessarily represent the views of the National Institutes of Health.
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Abstract

Objective The aim of this study was to evaluate whether being small for gestational age (SGA) or large for gestational age (LGA) or having a small or large head circumference (HC) at birth is associated with adverse neurodevelopmental outcomes.

Study Design This is a secondary analysis of a multicenter negative randomized trial of thyroxine therapy for subclinical hypothyroid disorders in pregnancy. The primary outcome was child intelligence quotient (IQ) at 5 years of age. Secondary outcomes included several neurodevelopmental measures. Associations between the outcomes in children with SGA (<10th percentile) or LGA (>90th percentile) birth weights, using ethnicity- and sex-specific population nomogram as well as nomograms from the National Fetal Growth (NFG) study, were compared with the referent of those with appropriate for gestational age (AGA) birth weight. Similar analyses were performed for HC.

Results Using the population nomogram, 90 (8.2%) were SGA and 112 (10.2%) were LGA. SGA neonates were more likely to be born preterm to mothers who were younger, smoked, and were less likely to have less than a high school education, whereas LGA neonates were more likely to be born to mothers who were older and have higher body mass index, compared with AGA neonates. SGA at birth was associated with a decrease in the child IQ at 5 years of age by 3.34 (95% confidence interval [CI], 0.54–6.14) points, and an increase in odds of child with an IQ < 85 (adjusted odds ratio [aOR], 1.9; 95% CI, 1.1–3.2). There was no association between SGA and other secondary outcomes, or between LGA and the primary or secondary outcomes. Using the NFG standards, SGA at birth remained associated with a decrease in the child IQ at 5 years of age by 3.14 (95% CI, 0.22–6.05) points and higher odds of an IQ < 85 (aOR, 2.3; 95% CI, 1.3–4.1), but none of the other secondary outcomes. HC was not associated with the primary outcome, and there were no consistent associations of these standards with the secondary outcomes.

Conclusion In this cohort of pregnant individuals with hypothyroid disorders, SGA birth weight was associated with a decrease in child IQ and greater odds of child IQ < 85 at 5 years of age. Using a fetal growth standard did not appear to improve the detection of newborns at risk of adverse neurodevelopment.

Keywords

birth weight - head circumference - neurodevelopmental outcomes - child IQ

Supplementary Material



Publication History

Received: 09 May 2022

Accepted: 19 December 2022

Article published online:
15 February 2023

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