Home > Funded Projects > (SDAS) Etiological Subgroups Of Small-For-Gestational-Age: Differential Child Outcomes
(SDAS) Etiological Subgroups Of Small-For-Gestational-Age: Differential Child Outcomes
Project Number: R40MC26816 Grantee: Research Fdn of State University of NY Department/Center: Pediatrics Behavioral Medicine Project Date: 04/01/2014
Xiaozhong Wen, MD, PhD Assistant Professor 3435 Main St., Bldg. 26 G56 Farber Hall Buffalo, NY 14214 Phone: (716) 829-6811 Email: firstname.lastname@example.org
Perinatal/Infancy (0-12 months)
Toddlerhood (13-35 months)
Early Childhood (3-5 years)
Middle Childhood (6-11 years)
This project will address MCHB Strategic Research Issue #IV, "Promoting the healthy development of MCH populations". It contributes to tailored interventions for children born small-for-gestational-age (SGA).
Healthy intrauterine environment and normal fetal growth are critical for promoting healthy child development and lifelong well-being. But about 10% of U.S. children are born SGA,1 due to various genetic and environmental causes. On average, children born SGA have worse physical and cognitive development than children born appropriate-for-gestational-age (AGA),2 and thus may have special needs for healthcare, feeding, and parenting. However, there is a great deal of heterogeneity among SGA newborns, potentially due to different etiology. Current guidelines for clinical management of SGA newborns emphasize intensive growth surveillance and growth hormone therapy for persistent short stature after age 2-3 y.3,4 One limitation of these guidelines is failure to consider that SGA has at least 7 different key prenatal causes: maternal prepregnancy underweight, short stature, smoking during pregnancy, alcohol use, inadequate gestational weight gain, hypertensive conditions, and genital or urinary tract infection, and may need tailored interventions depending on the cause(s). Considering these prenatal causes could allow more accurate prediction of later
outcomes among SGA newborns and potentially inform tailored interventions that are
more effective than universal intervention. However, this can only be possible with a better understanding of child outcomes of SGA with different etiology.
The overall goal of the proposed study is to identify which etiological subgroups of SGA have adverse child outcomes up to age 7 years (y). Guided by a life course framework, we will use data from two U.S. national longitudinal birth cohorts that tracked mother-child dyads from pregnancy to age 5-7 y: 1) The Early Childhood Longitudinal Study - Birth (ECLS-B, N=10,700, SGA 1,431),5,6 2) The Collaborative Perinatal Project (CPP, N=59,500, SGA 4,860).7-9 Our team has access to both datasets, and published 4 peer-reviewed journal articles on maternal and child health
using CPP data since 2010.10-13 Aim 1: compare physical (e.g. weight, height, blood
pressure) and cognitive (e.g. IQ, achievement) outcomes from birth to age 7 y across
etiological subgroups of SGA based on 7 key prenatal risk factors. Aim 2: examine
whether the associations between etiological SGA subgroups and child outcomes in the
Aim 1 can be modified by postnatal factors including infancy feeding, well-child care,
catch-up growth, and parenting. Aim 3: build and validate prediction models for child
outcomes among SGA newborns using socio-demographics and prenatal risk factors.
Low Birthweight, Physical Growth, Cognitive &
Linguistic Development, Social & Emotional Development, Pregnancy, Smoking,
Nutrition & Diet, Breastfeeding