New Criteria for Extrauterine Growth Restriction in Very Low-birth-weight Preterm Children and Neuropsychological Development at the Beginning of Primary School.

Abstract Controversy between short-term neonatal growth of very low birth-weight preterm (VLBW) and neurodevelopment may be affected by new criteria of intra- and extrauterine growth restriction (IUGR and EUGR). Objective: To determine if IUGR and IUGR classic and new criteria are related to the neuropsychological development in VLBW. Patients and methods: 87 VLBW were studied at 5–7 years. Neuropsychological assessment included RIST test and NEPSY-II tests. Results of these tests were related to IUGR and EUGR classification using Fenton and INTERGROWTH-21 (IGW-21) graphs and standards. Results: Weight IUGR by Fenton and IGW-21 was 37.9 and 39.1% (Kappa 0.879). Classic (static) EUGR was 89.7% and 75.9%, respectively (Kappa 0.532). “True” EUGR was 52.9% and 36.8% (Kappa 0.683). Result of the RIST index was correlated with Fenton´s z-score weight (0.034), length (< 0.001) and head circumference (HC) (< 0.001) at birth; with IGW-21´s length (0.002) at birth; with Fenton´s weight (0.004) and length (0.003) at neonatal discharge; and with IGW-21´s weight (0.004) and length (0.003) at neonatal discharge. We found statistically significant differences in IQ when comparing cases with and without IUGR of weight, length and HC by Fenton; and length and HC by IGW-21; also we found differences in static EURG for length and HC for Fenton and IGW-21. In NEPSY-II subtasks we found some relationship in inhibitory control and visuospatial abilities. Conclusion: IUGR and EUGR classic and new concepts show different classification percentages of VLBW. This should be considered when assessing relationships with risk of alterations in neuropsychological tests at school initiation, due to the different results found depending on the classification criteria chosen.