Neurodevelopmental significance of minor and major congenital anomalies in neonatal high risk children.

Minor and major congenital anomalies were studied in 395 neonatal risk children and 107 normal school children at the age of nine in the context of follow-up of the risk children. The purpose of the study was to evaluate the impact of early prenatal disturbances on the long term prognosis. Minor physical anomalies (MPA) were scored by a weighted scoring system modified from that of Waldrop and Halverson. The children with minor or major congenital anomalies performed worse in a cognitive test (WISC) and in a motor performance test. The differences were significant in the neonatal risk group. There were more small for gestational age (SGA) children in the anomaly group of the neonatal risk group as a whole and in the low birthweight group than in the non-anomaly group. Hyperactivity was associated with a high MPA score in the comparison group, but not in the study group. The results are consistent with earlier reports of associations between intrauterine growth disturbance and minor physical anomalies. Our findings suggest an additive effect of prenatal insults and neonatal risk factors in the origin of neurodevelopmental disturbances.