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Published on: February 18, 2012
Growth in very preterm children: a longitudinal study
Aimon Niklasson1, Eva Engstrom, Anna-Lena Hard
1Göteborg Pediatric Growth Research Centre, Department of Pediatrics, The Queen Silvia Children's Hospital, S-416 85 Göteborg, Sweden. aimon.niklasson@vgregion.se
Insights
Very preterm children experience initial growth delays but achieve normal growth by age 7. Earlier gestational age at birth correlates with later catch-up growth in these children.
Area of Science:
- Pediatrics
- Neonatology
- Human Growth and Development
Background:
- Long-term growth patterns in very preterm infants (<29 weeks gestational age) remain incompletely understood.
- Gestational age at birth is a critical factor influencing infant development and long-term outcomes.
Purpose of the Study:
- To investigate the longitudinal growth of very preterm children from birth to 7 years of age.
- To analyze growth trajectories in relation to gestational age at birth.
Main Methods:
- Retrospective study of 52 surviving very preterm children born between 1988-1991.
- Longitudinal growth data collected from birth to 7 years of corrected age.
Main Results:
- Most infants experienced initial weight decrease followed by catch-up, with peak weight gain at 36-40 weeks postmenstrual age.
- Weight and length velocity increased between 6 months and 2 years, with further catch-up growth observed at 4-5 years.
- By 7 years, all but two children reached normal population height ranges, with earlier gestational age linked to later catch-up.
Conclusions:
- Very preterm infants exhibit initial growth retardation that takes 4-7 years to overcome.
- Despite initial challenges, the cohort achieved normal height, weight, and weight-for-height by pre-puberty.
- Gestational age is a significant determinant of the timing and extent of catch-up growth in extremely preterm infants.
Abstract:
The knowledge about the long-term growth of very preterm children in relation to gestational age at birth is incomplete. Therefore, a retrospective study of longitudinal growth from birth to 7 y of age in 52 of 56 surviving children who were born at a gestational age of <29 wk between 1988 and 1991 to mothers resident in the city of Göteborg, Sweden, was performed. A majority of the children had an initial decrease in weight during the first months of life, followed by an increase, with a maximum weight gain occurring at 36-40 wk postmenstrual age. After a period of decreased weight and length velocity, a second increase in weight velocity was demonstrated from 6 mo to 2 y of corrected age. A corresponding increase in length velocity was found from 2 to 12 mo of corrected age. A later catch-up growth period was found at 4-5 y of age. At 7 y of age, all but two had reached the normal height range of the population. This long-term catch-up in height was established later in those who were born at an earlier gestational age. We conclude that all preterm infants had an initial period of poor growth, which rendered them growth retarded during the first years of life. It took approximately 4-7 y to overcome what the very preterm child lost in growth during the first months of life. However, as a group, they did reach normal height, weight, and weight for height before puberty.
