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Previous studies have shown that both fetal size and gestational age have associations with cognitive or academic outcomes. This study aimed to determine whether the association between gestational age (37\u201341\u2009weeks) and child intelligence is moderated by fetal size in term\u2010born children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data were harmonized for four national cohorts in the USA, UK, Ireland, and Australia. Predictors included fetal size and gestational age. Fetal size was calculated using Fenton's chart and grouped into three categories: Large for gestational age (LGA) (&gt;90th percentile), appropriate for gestational age (AGA) (10th to 90th percentile), and small for gestational age (SGA) (&lt;10th percentile). The outcome was intelligence quotient (IQ) scores at age 5\u2009years. Linear models, contrast analyses, and point plots were employed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In total, 30\u2009035 term\u2010born participants were included in the analysis. Overall, being born before 41\u2009weeks and being born with SGA (but not LGA) were both negatively associated with IQ. No statistically significant interactions between fetal size category and gestational age at term were found. At each gestation from 37 to 41\u2009weeks, being born SGA (but not LGA) was associated with lower IQ when compared to AGA. A small but clinically significant reduction in IQ (i.e., 0.23 IQ\n                      <jats:italic>Z<\/jats:italic>\n                      \u2010score, equivalent to a 3.45 IQ difference) was found in SGA\u2010born children who were born at 37\u2009weeks compared to 41\u2009weeks.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The association between gestation and child IQ at age 5 was not moderated by fetal size in term\u2010born children. Regardless of gestational age at term, SGA (but not LGA) is consistently and unfavorably associated with poorer cognitive outcomes. The IQ at age 5 was only clinically meaningfully decreased in SGA children born at 37\u2009weeks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.70671","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T10:07:31Z","timestamp":1763374051000},"page":"791-800","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Fetal size, gestational age, and cognitive performance at 5\u2009years in term\u2010born children: Four national cohorts' study"],"prefix":"10.1002","volume":"173","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1664-2078","authenticated-orcid":false,"given":"Xuan","family":"Zhao","sequence":"first","affiliation":[{"name":"Department of Psychology, Lifespan Health and Wellbeing Group University of Warwick  Warwick UK"},{"name":"Warwick Medical School University of Warwick  Warwick UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0476-1811","authenticated-orcid":false,"given":"Robert","family":"Eves","sequence":"additional","affiliation":[{"name":"Department of Psychology, Lifespan Health and Wellbeing Group University of Warwick  Warwick UK"},{"name":"Fakult\u00e4t f\u00fcr Psychologie und Sportwissenschaft Universit\u00e4t Bielefeld  Bielefeld Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3221-5471","authenticated-orcid":false,"given":"Siobhan","family":"Quenby","sequence":"additional","affiliation":[{"name":"Warwick Medical School University of Warwick  Warwick UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1314-6194","authenticated-orcid":false,"given":"Sakari","family":"Lemola","sequence":"additional","affiliation":[{"name":"Fakult\u00e4t f\u00fcr Psychologie und Sportwissenschaft Universit\u00e4t Bielefeld  Bielefeld Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0304-268X","authenticated-orcid":false,"given":"Dieter","family":"Wolke","sequence":"additional","affiliation":[{"name":"Department of Psychology, Lifespan Health and Wellbeing Group University of Warwick  Warwick UK"},{"name":"Warwick Medical School University of Warwick  Warwick UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,17]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2012.04.016"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2010.12.023"},{"key":"e_1_2_10_4_1","unstructured":"ChrissieY.UK C\u2010Section Rates 2023: Stats Perspectives & Guidance 2023.2023. 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