Associations between EFW and kindergarten-age child
development
For both the INTERGROWTH and WHO charts, estimated fetal weight
percentile was positively associated with EDI scores, with lower median
test scores and higher risks of developmental vulnerability among
smaller infants (Figure 1 ). However, the magnitude of the
differences between smaller fetuses and those between the
31st to 90th percentile was
generally modest (Tables 2 and 3 ). For example, children with
an estimated fetal weight between the 31st to 90th centile of the
INTERGROWTH chart had a mean EDI score of 40.6, while infants between
the 3rd to 9th centile had a mean score of 37.8; a mean difference
between the scores of only -2.8 [95% CI: -5.1, -0.5]. The most
pronounced difference was observed among children who were
<3rd percentile of the WHO chart, whose EDI
scores were -4.7 [95% CI: -7.1,-2.3] lower than those with an EFW
between the 31st and 90thpercentile.
The risks of developmental vulnerability were lowest among children with
an EFW between the 31st and 90thpercentile (30.1% risk using the INTERGROWTH chart, 29.2% risk using
the WHO chart). Risks were increased in lower EFW categories (e.g.,
35-40% in categories <20th percentile of
the INTERGROWTH chart, and 35-45% in
categories<20th percentile of the WHO
chart, Tables 2 and 3 ). Risk ratios for these differences were
significantly different than the null for some, but not all of these
lower percentile categories. Similar trends were observed for the two
EDI subscales (Figure S1 ), and special needs designation
(Figure S2 ), although small numbers for this latter outcome
precluded firm conclusions.