Pre- and perinatal factors in long-term development : behavioral and intellectual performance for boys and girls at school age as related to birth weight and gestational age, with special regard to maternal hormone levels and smoking during pregnancy
Sammanfattning: The aim of the present work was to investigate long-term intellectual and behavioral development in relation to pre- and perinatal factors, with emphasis on birth weight and gestational age, for boys and girls at school age. The first part of the work consists of a short-term longitudinal clinical study of pregnant women in risk pregnancies. The women were continuously monitored from pregnancy week 16-17 until about four days post-partum with, among other tests, investigations of maternal serum hormone levels. The results indicated that the maternal hormone balance was affected by smoking depending upon the sex of the fetus, and that differences in maternal hormone patterns were related to pre-term and to small-for-gestational age (SGA) deliveries. The second part of the work consists of long-term longitudinal studies where cognitive and behavioral development of children at the ages of 10-13 years were related to pre- and perinatal factors. The subjects consisted of two representative samples, and one clinically defined sample, namely; a) the research project Individual Development and Adjustment, b) the research Project Metropolitan, and c) children born to mothers who had participated in a clinical study during their pregnancy. The results indicated that children who were SGA tended to have suboptimal intelligence and scholastic performance which was less pronounced for appropriate-for-gestational age (AGA) children. There were sex-related differences in intelligence, scholastic performance, and behavior related to pre- and perinatal factors. The low birth weight girls showed more behavior disorders and poorer scholastic performance than did normal birth weight girls. Girls born to smoking mothers had lower scores in WISC verbal tests than did girls of non-smoking mothers. These findings were not obtained for the corresponding groups of boys. Maternal serum hormone levels (hCG and hPL) during pregnancy were correlated to outcome of WISC test scores for SGA girls at the age of 10 years. The findings might emphasize a vulnerability in the fetus as related to sex of fetus, which might have farreaching implications. Disparity in maturity between infants born AGA and SGA, and consequences of early or late onset of SGA during pregnancy were discussed, as well as medically-at-risk childrens’ parental socioeconomic situation.
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