Fetal Programming of Infant Neuromotor Development: The Generation R Study

Abstract

ABSTRACT:The objective of the study was to examine whether infant neuromotor development is determined by fetal size and body symmetry in the general population. This study was embedded within the Generation R Study, a population-based cohort in Rotterdam. In 2965 fetuses, growth parameters were measured in mid-pregnancy and late pregnancy. After birth, at age 9 to 15 wks, neuromotor development was assessed with an adapted version of Touwen's Neurodevelopmental Examination. Less optimal neuromotor development was defined as a score in the highest tertile. We found that higher fetal weight was beneficial to infant neurodevelopment. A fetus with a 1-SD score higher weight in mid-pregnancy had an 11% lower risk of less optimal neuromotor development (OR: 0.89; 95% CI: 0.82-0.97). Similarly, a fetus with a 1-SD score larger abdominal-to-head circumference (AC/HC) ratio had a 13% lower risk of less optimal neuromotor development (OR: 0.87; 95% CI: 0.79 -0.96). These associations were also present in late pregnancy. Our findings show that fetal size and body symmetry in pregnancy are associated with infant neuromotor development. These results suggest that differences in infant neuromotor development, a marker of behavioral and cognitive problems, are at least partly caused by processes occurring early in fetal life. (Pediatr Res 67: 132-137, 2010)

The Generation R Study: design and cohort update 2012

“…At the age of 3 months, home visits were performed to assess neuromotor development using an adapted version of Touwen's Neurodevelopmental examination [183][184][185]. Information about growth (length (height), weight, head circumference) is collected at each visit to the routine child health centres in the study area using standardized procedures.…”

Somatic growth trajectory in the fetus with hypoplastic left heart syndrome

“…Given the importance of BWT (1,2) and gestational age (18,19) as predictors of clinical outcome in CVMs, the observation is important. However, the fetal growth patterns underlying these BWT observations are largely unknown and may influence shortand long-term neurodevelopmental outcomes (10). Both somatic growth and brain growth (20,21) may be adversely effected in HLHS.…”

“…The relationship between growth and clinical outcomes can be further refined through an understanding of the pattern or trajectory of intrauterine growth across gestation (9). Serial measurements, obtained noninvasively by ultrasound, may be used to identify differential growth patterns, which may influence both short and long-term clinical outcomes (10). These patterns have not been described in the fetus with HLHS.…”

Baixo peso ao nascer e proficiência motora em crianças: uma revisão sistemática

“…Hui et al 33 verificaram que quanto menor o peso ao nascer das crianças, maior eram o crescimento na idade de zero a três meses e o índice de massa corporal aos 7 anos de idade, quando comparadas às crianças nascidas com peso normal. Batenburg-Eddes et al 34 verificaram que fetos com menor peso corporal ou com o crescimento assimétrico tinham maior probabilidade de apresentarem deficits no desenvolvimento neuromotor na infância. Portanto, a condição ambiental no início da vida tem impacto significativo em vários aspectos do desenvolvimento fetal 32,35,36 .…”