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Catch-up growth in 166 small-for- gestational age premature infants weighing less than 1,000 g at birth
M Monset-Couchard1, O de Bethmann
1Neonatal Intensive Care Unit, CHU Cochin, AP-HP, Université Paris V René-Descartes, Paris, France.
Insights
Most extremely low birth weight and small-for-gestational age children achieve catch-up growth in height, weight, and head circumference by age three. Some short children may benefit from growth hormone therapy.
Area of Science:
- Pediatrics
- Neonatology
- Growth and Development
Background:
- Extremely low birth weight (ELBW) and small-for-gestational age (SGA) infants face challenges in achieving optimal growth.
- Understanding catch-up growth patterns is crucial for assessing long-term outcomes in these vulnerable populations.
Purpose of the Study:
- To evaluate the achievement of catch-up growth in height, weight, and head circumference in ELBW/SGA children.
- To identify factors influencing catch-up growth and potential benefits of growth hormone therapy.
Main Methods:
- Longitudinal study of 166 ELBW/SGA children followed for 4-18 years.
- Categorization into three groups based on SGA severity using Lubchenco and Mamelle curves.
- Catch-up growth defined as reaching and maintaining -2 SD of French reference data for height, weight, and head circumference.
Main Results:
- 81% achieved catch-up height, 79% catch-up weight, and 81% catch-up head circumference.
- Catch-up growth for all three parameters was achieved in 65% of children by age three.
- Seven children received growth hormone; one showed catch-up growth.
Conclusions:
- The majority of ELBW/SGA children achieve significant catch-up growth within the first three years.
- While weight and head circumference catch-up are common, height may require further intervention.
- Growth hormone therapy is a potential consideration for short children who do not achieve adequate height catch-up.
Abstract:
Catch-up growth was studied in 166 children born with an extremely low birth weight (<1,000 g) and small-for-gestational age (SGA, <10th percentile birth weight for gestational age). Of these children 159 were followed up for between 4 and 18 years (median 9 years). Group A, SGA <10th percentile of Lubchenco curves only; group B, <10th percentile of Mamelle's curves but >5th percentile, and group C, <5th percentile of Mammelle's curves. Catch-up growth was considered to be achieved when height, weight, and head circumference (HC) reached -2 SD of French reference data and remained above this limit afterwards. Catch-up growth in height was achieved in 126/156 children or 81% (group A 88%; group B 84%; group C 74%), before 3 years of age in 100/127 (78%). Seven children below -2 SD received growth hormone (1 child who caught up was excluded from the results). Catch-up growth in weight was achieved in 126/159 children or 79% (group A 86%; group B 82%; group C 73%), before 3 years of age in 87/126 (69%). Catch-up growth in HC was achieved in 126/156 or 81% (group A 78%; group B 92%; group C 77%), before 3 years of age in 102/127 (80%). Overall catch-up growth was achieved for all three parameters in 65% of children, two of three parameters in 19%, and one of three parameters in 8%. Eleven children never caught up on any parameter. While weight is a lesser concern and HC is not liable to intervention, a greater number of short children might benefit from growth hormone therapy.