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.