Severe Intrauterine Growth Retardation: Developmental Newborn Intensive Care Unit (NICU) Care

The purpose of the study is to learn more about the development of small for gestational age (SGA) preterm infants and whether focusing on the infant's behavior has a positive effect on outcome. The study hypotheses state: 1) High risk severely SGA preterm infants will profit from detailed neuropsychological assessment, psychoeducational recommendations and practical guidance for caregiving, as well as formal educational and emotional support for the family and the professional care team. 2) Neuropsychological education and guidance for community-based early intervention providers caring for SGA preterm infants after their discharge is effective in promoting improved outcome.

Inclusion Criteria: * Inborn at the Brigham and Women's Hospital * Gestational age \< 36 weeks * Birthweight \< 5th percentile * Head circumference at birth \< 5th percentile Exclusion Criteria: * Presence of major chromosomal or congenital anomalies (Down's, Turner's, Klinefelter's Syndrome, etc.) * Presence of major congenital infections (HIV, TORCH) * Presence of significant prenatal focal brain lesions (intrauterine infarcts; cystic changes, etc.) * Presence of major maternal illness (uncontrolled diabetes, active seizure disorder requiring medication during pregnancy, renal transplant), mental and/or emotional impairment (including heroin addiction and documented alcoholism)