Research Article
Infants Born Large for Gestational Age and Developmental
Attainment in Early Childhood
Cairina E. Frank,
1,2
Kathy N. Speechley ,
1,2,3
Jennifer J. Macnab,
1
and M. Karen Campbell
1,2,3,4
1
Department of Epidemiology and Biostatistics, University of Western Ontario, London, ON, Canada
2
Children’s Health Research Institute, Lawson Health Research Institute, London, ON, Canada
3
Department of Pediatrics, University of Western Ontario, London, ON, Canada
4
Department of Obstetrics and Gynecology, University of Western Ontario, London, ON, Canada
Correspondence should be addressed to M. Karen Campbell; karen.campbell@schulich.uwo.ca
Received 23 August 2017; Accepted 28 November 2017; Published 1 January 2018
Academic Editor: Samuel Menahem
Copyright © 2018 Cairina E. Frank et al. Tis is an open access article distributed under the Creative Commons Attribution License,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objectives. To investigate if an association exists between being born large for gestational age (LGA) and verbal ability or
externalizing behaviour problems at ages 4-5 years. Method. A secondary analysis was conducted using the National Longitudinal
Survey of Children and Youth, including singleton births in 2004-2005 followed till 4-5 years ( = 1685). LGA was defned as a
birth weight > 90th percentile. Outcomes included poor verbal ability (scoring < 15th percentile on the Revised Peabody Picture
Vocabulary Test) and externalizing behaviour problems (scoring > 90th percentile on externalizing behaviour scales). Multivariable
logistic regression with longitudinal standardized funnel weights and bootstrapping estimation were used. Results. Infants born
LGA were not found to be at increased risk for poor verbal ability (aOR: 1.16 [0.49, 2.72] and aOR: 0.83 [0.37, 1.87] for girls and
boys, resp.) or externalizing behaviour problems (aOR: 1.24 [0.52, 2.93] and aOR: 1.24 [0.66, 2.36] for girls and boys, resp.). Social
factors were found to impact developmental attainment. Maternal smoking led to an increased risk for externalizing behaviour
problems (aOR: 3.33 [1.60, 6.94] and aOR: 2.12 [1.09, 4.13] for girls and boys, resp.). Conclusion. Tere is no evidence to suggest
that infants born LGA are at increased risk for poor verbal ability or externalizing behaviour problems.
1. Introduction
Infant birth weight (BW) is both a marker of prenatal condi-
tions and a strong predictor of neonatal health outcomes [1].
It has been noted that there is a reverse J-shaped relationship
between birth weight and a number of adverse outcomes [2].
Te majority of the literature has focused on those born small
for gestational age (SGA). However, infants born large for
gestational age (LGA) have been shown to have a higher risk
of adverse obstetrical outcomes as well as future metabolic
defcits [3].
Tere is sparse and inconclusive literature examining
whether being born LGA is associated with an elevated risk of
poorer developmental attainment. Using a large cohort study,
Alati et al. found a positive association between being born
LGA and social disorder symptoms (aOR: 1.57 [1.12, 2.20])
[4], while other studies have reported increased risk for
externalizing behaviour problems (aOR: 1.39 [1.02, 2.78])
[5]. Associations have also been reported with schizophrenia
[2], cognitive function [6], and autism spectrum disorder
[7]. However, there have also been studies with contrasting
results for each of the above associations [8–10]. Within this
literature, few studies have considered pertinent confounding
variables and most have focused on late childhood or early
adolescence, ignoring a signifcant period of development
[10, 11].
Tere are several reasons to speculate that LGA infants
may be at a higher risk for poor development compared to the
general population. Preexisting maternal conditions leading
to LGA may themselves be related to later development. For
example, maternal diabetes and obesity can result in fetal
hyperinsulinemia, infammation, and hormonal dysfunction
Hindawi
International Journal of Pediatrics
Volume 2018, Article ID 9181497, 7 pages
https://doi.org/10.1155/2018/9181497