Strength and limitations
The present study utilizes a novel technique –recordings of the
so-called frequency-following response– to assess CNS functionality in
LGA neonates during the first days of life. The neonatal sample was
selected from non-diabetic mothers, a well-known risk factor for poor
infant neurodevelopment68,69, making it possible to
assess specifically the effect of neonatal high birth weight on CNS
functionality, free of maternal disease influences. Yet, the present
results should be interpreted with caution, as key limitations include
sample size, potential confounds, single-center origin, and the lack of
postnatal follow-up. Our sample was indeed small but yet similar to that
of previous electrophysiological studies on other clinical
conditions43-47. Also, we acknowledge that our results
were obtained on a sample recruited from one single maternity unit.
Future multi-centric studies should increase external validity.
Furthermore, the inclusion of a much larger number of cases would allow
us conduct multiple regression analysis to control for potential
confounds, such as maternal smoking. Follow-up studies should aim at
determining whether the CNS alterations observed at birth are only
transient to normalize with development or, otherwise have a potential
predictive value. In the next stage of our project, we pursue assessing
neurodevelopment at the age of 2 years. The existence of previous
studies demonstrating that the FFR can predict literacy scores one year
ahead48 makes us confident that it will be possible to
corroborate a relationship between the neonatal FFR and
neurodevelopmental test scores.