Extremely preterm infants small for gestational age are at risk for motor impairment at 3years corrected age

Background: Few studies have targeted psychomotor development and associated perinatal risk factors in Japanese very low birth weight (VLBW) infants who are severely small for gestational age (SGA). Design/subjects: A single-center study was conducted in 104 Japanese VLBW infants who were born preterm, due to maternal, umbilical cord, or placental abnormalities, between 2000 and 2007. Psychomotor development as a developmental quotient (DQ) was assessed using the Kyoto Scale of Psychological Development at 3. years corrected age. Severely SGA was defined as birth weight or length below -2 standard deviation values of the mean values at the same gestation. VLBW infants were divided into 2 subgroups based on gestational age at birth: ≥28. weeks (n= 64) and <28. weeks (n= 40). DQs of infants with severe SGA were compared with those of infants who were appropriate for gestational age (AGA). Factors associated with developmental disabilities in VLBW infants with severe SGA (n= 23) were determined. Results: In the group born at ≥28. weeks gestation, infants with severe SGA had normal DQ values and did not significantly differ from those with AGA. However, in the group born at <28. weeks gestation, severe SGA infants had significantly lower postural-motor DQ values than AGA infants. Gestational age <28. weeks was an independent factor for low postural-motor DQ, regardless of the cause of severe SGA or pregnancy termination. Conclusions: Extremely preterm newborns with severe SGA are at risk of motor developmental disability at age 3 years.