Neural vulnerability and behavioral development in infants with intrauterine growth restriction (IUGR): mechanisms and outcomes

Intrauterine growth restriction is defined as a fetal growth retardation, resulting in an estimated fetal weight below the 10th centile for gestational age. Developing brain of IUGR infants is affected by the atypical fetal growth, presenting altered structure and connectivity, exposing to an increased risk for neurodevelopmental impairments. Behaviorally, IUGR infants show reduced responsiveness and engagement with human faces. The present work reports on the interconnected role of neural and environmental factors involved in IUGR developmental trajectories. Specifically, results of: i) a meta-analysis; ii) an MRI case-control study; and iii) preliminary findings of a longitudinal behavioral study will be presented. Meta-analysis shows increased risk for cognitive outcomes in IUGR vs appropriate for gestational age (AGA) peers across childhood, both for preterm and term-born children. The MRI case-control study highlights significant differences in brain volumes in several regions for IUGR preterm vs AGA preterm newborns at term-equivalent. Last, the longitudinal study suggests that low birth weight is significantly associated with atypical patterns of mother-infant interaction at 4 months, namely in visual and verbal contact. Taken together these findings have implications for identifying antenatal impacts of IUGR on child development and proposing clinical strategies to constrain the effects of atypical brain growth and behavioral development on later outcomes.