Growth and neurodevelopment outcome in symmetric versus asymmetric small for gestational age term infants

OBJECTIVE: Few studies compared growth and neurodevelopment outcome between asymmetric (aSYM) and symmetric (SYM) small for gestational age (SGA) term infants. We aimed at evaluating their respective outcome at 9 months postnatal age. STUDY DESIGN: A cohort study including infants born in 2010 to 2011 with a birth weight <5th centile and a head circumference (HC) below (SYM) or above (aSYM) the 5th centile. Catch-up growth was defined as weight, height and HC >=-2 s.d. of World Health Organization reference values. Neurodevelopment was evaluated with Brunet-Lezine test items. RESULT: Of 6586 infants, 194 were SGA: 38.7% SYM and 61.3% aSYM. The aSYM group showed better catch-up growth (85% versus 70%, P=0.03) with larger HC (44.9 +/- 1.6 versus 43.7 +/- 1.2 cm, P<0.0001). No difference in neurodevelopmental screening was observed between SGA groups, but infants without any catch-up growth were at higher risk of delayed outcome. CONCLUSION: Term SGA infants must be closely followed, regardless of their characteristics, to improve their outcome.