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Socioeconomic differences and the impact of being small for gestational age on neurodevelopment among preschool-aged children

机译：学龄前儿童的社会经济差异以及胎龄偏小对神经发育的影响

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Background: Studies of small for gestational age (SGA) birth and subsequent childhood cognitive outcomes are inconsistent. Few studies have assessed whether effects varied by socioeconomic status (SES). Objective: To assess child cognitive and behavioral outcomes according to SGA and severe SGA (<10th and <5th percentiles) and SES. Methods: We followed 474 infants initially selected for a case-control study assessing SGA vs. appropriate-for-gesta-tional age (AGA). The infants were born at two hospitals: a public hospital serving a low-income, African-American population and a private hospital serving a predominantly white, middle-class population. At age 54 months, a psychologist administered the Differential Abilities Scales (DAS), and Vineland Adaptive Behavior Scales (VABS). The mother completed the Child Behavior Checklist (CBCL). Associations were analyzed using multiple linear regression. Results: Among AGA children, the mean DAS score was >1 standard deviation lower for children born at the public vs. the private hospital (75.2 vs. 95.7 among boys; 76.3 vs. 101.8 among girls). Being SGA had a weaker effect on DAS scores, overall. Severe SGA had a significant effect on DAS scores of children born at the private hospital (average reduction 8.0±2.5 points), but not on children born at the public hospital (average reduction 1.1±2.2 points). In the latter group, severe SGA was associated with a lower VABS score (average reduction 9.2±2.5 points). Conclusions: Poor fetal growth influences neurodevelopment, but this influence is modified by postnatal environment. Adverse effects associated with low SES might mask or attenuate associations between prenatal exposures and developmental outcomes in some populations.
机译：背景：关于胎龄小（SGA）出生和随后的儿童认知结果的研究不一致。很少有研究评估影响是否因社会经济地位（SES）而异。目的：根据SGA和严重SGA（<10％和<5％）和SES评估儿童的认知和行为结局。方法：我们追踪了最初被选入病例对照研究的474名婴儿，以评估SGA与适合胎龄（AGA）的关系。这些婴儿在两家医院出生：一家为低收入的非裔美国人人口服务的公立医院，和一个主要为白人，中产阶级人口服务的私立医院。在54个月大时，心理学家使用了差异能力量表（DAS）和葡萄园适应行为量表（VABS）。母亲填写了儿童行为清单（CBCL）。使用多元线性回归分析关联。结果：在AGA儿童中，在公立医院和私立医院出生的孩子的DAS平均得分低> 1个标准差（男孩分别为75.2和95.7；女孩分别为76.3和101.8）。总体而言，成为SGA对DAS分数的影响较小。严重的SGA对在私家医院出生的孩子的DAS评分有显着影响（平均降低8.0±2.5分），而对在公立医院出生的孩子的DAS得分却没有影响（平均降低1.1±2.2分）。在后一组中，严重的SGA与较低的VABS评分相关（平均降低9.2±2.5分）。结论：胎儿发育不良会影响神经发育，但这种影响会因产后环境而改变。与低SES相关的不良反应可能会掩盖或减弱某些人群中产前暴露与发育结果之间的关联。

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