BMJ 1997;315:401-403 (16 August)

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Birth weight and cognitive function in young adult life: historical cohort study

Henrik Toft Sørensen, associate professor,a Svend Sabroe, associate professor,b Jørn Olsen, professor,b Kenneth J Rothman, professor,c Matthew W Gillman, associate professor,d Peer Fischer, consultant e

a Department of Internal Medicine V, Aarhus University Hospital, 8000 Aarhus C, Denmark, b Danish Epidemiology Science Centre, Department of Epidemiology and Social Medicine, University of Aarhus, 8000 Aarhus C, Denmark, c Department of Epidemiology and Preventive Medicine, Boston University School of Medicine, Boston, MA 02118, USA, d Department of Ambulatory Care and Prevention, Harvard Medical School and Harvard Pilgrim Health Care, Boston, MA 02215, USA, e Conscription Administration, County of North Jutland, 9000 Aalborg, Denmark

Correspondence to: Dr Toft Sørensen HTS@soci.aau.dk

Objective: To examine the relation between birth weight and cognitive function in young adult life.
Design: Retrospective cohort study based on birth registry data and cognitive function measured during evaluation for military service.
Subjects: 4300 Danish conscripts born between 1973 and 1975.
Main outcome measures: Mean score in the Boerge Prien test of cognitive function; score is the number of correct answers to 78 questions and correlates with full scale intelligence quotient (IQ).
Results: Mean score in the Boerge Prien test increased from 39.9 at a birth weight of <=2500 g to 44.6 at a birth weight of 4200 g even after adjustment for gestational age and length at birth, maternal age and parity, and other variables. Above a birth weight of 4200 g the test score decreased slightly.
Conclusion: Birth weight is associated with cognitive performance in young adult life. Interference with fetal growth may influence adult cognitive performance.

Key messages

  • Low birth weight and proportionate smallness at birth have been associated with poorer cognitive function in early childhood

  • Only a few studies have examined whether this association persists into adult life

  • This study found that the mean cognitive test score in 4300 Danish conscripts increased up to a birth weight of 4200 g after adjustment for confounders; there was a slight decrease above a birth weight of 4200 g

  • Fetal growth seems to influence adult cognitive performance

  • If fetal growth has an impact on mental development it has important consequences from the perspective of maternal care


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