Head Circumference and Cognitive Outcome in IUGR:A Systematic Review and Meta-Analysis

Introduction In intrauterine growth restriction (IUGR), variation of head circumference (HC) and impaired cognitive function have been reported. Objective To analyze HC and cognitive scores of IUGR vs. normal growth fetus (NGF). Methods A systematic review and meta-analysis were conducted based on the published articles in PubMed, Scopus, Web of Sciences, and ProQuest (2003/1/1–2023/12/31) using PRISMA guidelines and RevMan 5.4. The quality assessment of each article was conducted using the Newcastle–Ottawa Quality Assessment Scale (NOS). The study protocol was registered with the CRD42024547189 number in PROSPERO. Results The final articles included are 4 (155 IUGR, 375 NGF). Pooled results from the random-effects model showed that there was a significant difference in head circumference in IUGR (n = 155) vs. NGF (n = 375) of term + preterm [SMD= -0.42, 95% CI= -0.62 to -0.21, P < 0.0001; I2 = 0%, P = 0.79]; and IUGR (n = 128) vs. NGF (n = 326) of preterm newborns only [SMD= - 0.44, 95% CI= -0.67 to -0.21, P<0.0001; I2 = 0%, P = 0.67]. The Bayley-III cognitive scales between IUGR (n = 94) vs. NGF (n = 292) [SMD = - 0.30, 95% CI = - 0.66 to 0.07, P = 0.11; I2 = 28%, P = 0.24]. Conclusion Although there was a significant difference in the head circumference between IUGR and NGF, there were no considerable differences in cognitive achievement. These might be due to a successful effort during the catch-up period, when malnutrition and other factors are addressed