(SDAS) Etiological Subgroups Of Small-For-Gestational-Age: Differential Child Outcomes
Grantee: Research Fdn of State University of NY
Principal Investigator: Xiaozhong Wen
Project Number: R40MC26816
Project Date: 04/01/2014
Age group(s)
- Perinatal/Infancy (0-12 months)
- Toddlerhood (13-35 months)
- Early Childhood (3-5 years)
- Middle Childhood (6-11 years)
Abstract
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.Publications
Listed is descending order by year published.
Li X, Eiden RD, Epstein LH, Shenassa ED, Xie C, Wen X. Parenting and cognifive and psychomotor delay due to small-for-gestational age birth. J Child Psychol Psychiatry. 2017;58(2):169-179.
Li X, Eiden RD, Epstein LH, Shenassa ED, Xie C, Wen X. Etiological subgroups of small-for-gestational-age: differential neurodevelopmental outcomes. PLoS One. 2016 Aug 8;11(8):e0160677.
Xie C, Epstein LH, Eiden RD, et al. Stunting at 5 Years Among SGA Newborns. Pediatrics. 2016;137(2):1-10.
Xie C, Wang Y, Li X, Wen X. Childhood growth trajectories of etiological subgroups of large for gestational age newborns. J Pediatr. 2016;170:60-66.e1-e5.
Xie C, Wang Y, Li X, Wen X. Childhood growth trajectories of etiological subgroups of large-for-gestational-age newborns. J Pediatr, 2016 Mar;170:60-6.e1-5
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