Communication, narration, and reading and spelling skills in primary school-aged children born with fetal growth restriction.

This study investigated whether primary school-aged children born with fetal growth restriction (FGR) are at greater risk for poor communication, narrative skills, and reading and spelling skills than children born with appropriate for gestational age (AGA) growth. The participants belonged to a prospectively collected FGR cohort born in 1998−2001 at the Oulu University Hospital, Oulu, Finland. The mothers with placental insufficiency were recruited from the high-risk prenatal unit of the Oulu University Hospital, Oulu, Finland. This cohort of 73 FGR fetuses was followed-up prenatally until the deliveries at 24−40 gestational weeks. Gestational age was confirmed in all cases with ultrasound before 20 gestational weeks. Fetal growth restriction was defined as birth weight below the 10th percentile and/or significant placental insufficiency (umbilical artery pulsatility index > 2SD for gestational age). Neonates with chromosomal and structural anomalies were excluded. 36 AGA children (birth weight ≥ 10th percentile for gestational age) were selected for the control group and matched with gestational age and delivery within ± 2 weeks of the index FGR neonate. Children born with FGR had more difficulties with all the studied language-based skills than their gestational age and age-matched AGA peers.

Children born with FGR were more likely to have problems in communication skills than their AGA peers. The general communication skills according to the CCC-2 questionnaire, which embodies communication skills as a whole and gives a profile on the weaknesses and strengths of a child’s communication, were poorer for the FGR group than the AGA group. Children in the FGR group produced less informative and shorter narratives with simpler utterances than the children in the AGA group. Significantly more children in the FGR group performed below the 10th percentile normal values in word reading skills than children in the AGA group. 9- to 10-year-old third graders in the FGR group performed less well in word reading and spelling skills, reading fluency and accuracy, as well as in reading comprehension tasks than the third graders in the AGA group.

FGR was found to increase the risk for lower communication and narrative as well as reading and spelling skills at primary-school age. As language-based skills form a basis for learning abilities, the results of this study indicate a need for continuous linguistic evaluations of children born with FGR. Early identification of these problems is vital to providing preventive targeted support to children born with FGR to optimize their later academic performance.