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Ethnic differences in the growth of low-birthweight infants
P T Seed1, E M Ogundipe, C D Wolfe
1Department of Public Health Sciences, Guy's, King's and St. Thomas' School of Medicine, King's College London, UK. Paul.seed@kcl.ac.uk
Insights
Ethnic differences in low-birthweight infant growth were studied. Black preterm infants showed improved weight and head circumference catch-up compared to White infants, highlighting gestational age
Area of Science:
- Pediatrics
- Neonatology
- Human Growth and Development
Background:
- Low-birthweight infants face growth challenges.
- Ethnic variations in infant growth are not fully understood.
- Gestational age significantly impacts infant development post-birth.
Purpose of the Study:
- To investigate ethnic differences in growth patterns of low-birthweight infants.
- To compare growth trajectories from birth to 2-3 years across ethnic groups.
- To assess the influence of gestational age on catch-up growth in diverse ethnic populations.
Main Methods:
- Prospective study of 3091 low-birthweight live births in the South East Thames Region, UK.
- Weight and head circumference measurements at birth and 2-3 years compared to UK 1990 reference standards.
- Statistical adjustments for multiple factors including parity, maternal health, and socioeconomic status.
Main Results:
- Infants born at >= 32 weeks gestation showed significant weight catch-up; those < 32 weeks fell behind.
- Head circumference failed to keep pace for both gestational age groups.
- Black infants < 32 weeks gestation gained more weight and head circumference than White infants.
- Asian infants >= 32 weeks gestation had smaller head circumferences than White infants, a difference that widened over time.
Conclusions:
- Ethnic growth differences in low-birthweight infants are strongly linked to gestational age.
- Black preterm infants demonstrated better weight and head circumference maintenance compared to White infants.
- Gestational age is a critical factor in understanding ethnic disparities in infant growth outcomes.
Abstract:
Differences in growth were investigated among ethnic groups in low-birthweight babies (< 2500 g or < 32 weeks gestation) at birth and at 2-3 years. This prospective study was based on data for all 3091 low-birthweight live births in the South East Thames Region, UK, over a 1-year period, surviving to discharge from hospital. Weights were recorded at birth and at 2-3 years for 998 babies, and head circumferences for 859. These were compared with the UK 1990 reference standards. Ethnic differences were adjusted for parity, multiple birth, smoking and alcohol during pregnancy, mother's height, weight and age, marital status, partner's support and social class. At 2-3 years, there was substantial average catch-up growth only for the weight of infants of > or = 32 weeks' gestation. Babies < 32 weeks gestation had fallen behind. Head circumferences had failed to keep up or had fallen behind for both groups. The ethnic groups had similar birthweight standard deviation scores (SDS). At 2-3 years, Black babies of < 32 weeks' gestation had gained in weight and head circumference compared with White babies (adjusted difference in weight SDS: 0.71, [95% CI 0.28, 1.13]). Asian babies of at least 32 weeks' gestation had smaller heads than White, a difference that increased with time. It was concluded that ethnic differences in the growth of low-birthweight infants are related to gestational age. Although most of the babies born at < 28 weeks' gestation were close to their birthweight reference standards, only the Black infants had maintained their position at 2-3 years. Black infants, particularly when born preterm, tend to put on more weight than White.