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We thank Dr Belizán for his valuable comments. As he points out, several studies have found that infants born after symmetric growth restriction in utero have lower intellectual performance than those born after asymmetric growth restriction.1,2 However, Kramer et al3 argued in 1989 that symmetry among intrauterine growth-restricted infants is confounded by severity of growth restriction (ie, asymmetric intrauterine growth-restricted infants have …
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