Brain Development, Intelligence and Cognitive Outcome in Children Born Small for Gestational Age

Abstract

Intrauterine growth restriction (IUGR) can lead to infants being born small for gestational age (SGA). SGA is associated with increased neonatal morbidity and mortality as well as short stature, cardiovascular disease, insulin resistance, diabetes mellitus type 2, dyslipidemia and end-stage renal disease in adulthood. In addition, SGA children have decreased levels of intelligence and cognition, although the effects are mostly subtle. The overall outcome of each child is the result of a complex interaction between intrauterine and extrauterine factors. Animal and human studies show structural alterations in the brains of individuals with IUGR/SGA. The presence of growth hormone (GH) receptors in the brain implies that the brain is also a target for GH. Exogenous GH theoretically has the ability to act on the brain. This is exemplified by the effects of GH on cognition in GH-deficient adults. In SGA children, data on the effect of exogenous GH on intelligence and cognition are scant and contradictory.

Born Small for Gestational Age and Poor School Performance – How Small Is Too Small?

“…In a review from 2010, de Bie et al showed a subtle but statistically significant decrease in intelligence level and cognitive disabilities in children born SGA, even though different definitions of SGA make comparisons more difficult [10]. Other studies, with smaller cohorts, have shown results similar to ours, with a small but statistically increased risk of poor school performance and lower intelligence levels for children born SGA, but without looking at different levels of SGA within the same population [11, 31-33].…”

GH-IGF-IGFBP Axis and Metabolic Profile in Short Children Born Small for Gestational Age

“…SGA children have poorer school performance and have more emotional, conduct, and attention deficit hyperactivity disorders, although the differences are mostly subtle (de Bie et al, 2010;van Pareren et al, 2004). Adults who were born SGA show no difference in frequency of employment, marital status, or satisfaction with life.…”

Would banning atrazine benefit farmers?

“…It is an endocrine disrupter, causing feminization in male frogs and other species at very low concentrations; 2 it harms immune systems in exposed aquatic wildlife; 3 and exposure to it during pregnancy may increase risks of birth defects and low birth weight in humans. 4,5 Produced by Syngenta, a European chemical company, atrazine is subject to strict regulation that effectively prevents its use in Europe * -but it remains a staple of American agriculture. While the health and environmental effects of atrazine have been researched in depth, there has been only limited analysis of the economic impacts of atrazine use.…”