The EPICure study: growth and blood pressure at 6 years of age following extremely preterm birth
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Published on: January 7, 2018
M A Bracewell1, E M Hennessy, D Wolke
1School of Human Development, University of Nottingham, UK.
Insights
Extremely preterm children show persistent growth deficits into school age, with some catch-up growth. Blood pressure appears similar to term classmates despite early growth restriction.
Area of Science:
- Pediatrics
- Neonatology
- Growth and Development
Background:
- Preterm children face risks for reduced growth and potential blood pressure changes.
- Early childhood growth patterns may influence later health outcomes.
Purpose of the Study:
- To assess growth and blood pressure (BP) in extremely preterm (EP) children at age 6.
- To compare growth and BP of EP children with their term-born classmates.
Main Methods:
- Evaluated children born at ≤25 weeks gestation at age 6.
- Standardized assessments included auxology (growth measurements) and sitting BP.
- 160 full-term classmates served as a comparison group.
Main Results:
- EP children were lighter, shorter, with lower BMI and head circumference compared to classmates.
- EP children demonstrated catch-up growth in weight, height, and head circumference by age 6.
- Systolic and diastolic BP were lower in EP children, but differences were explained by height and BMI.
Conclusions:
- Postnatal growth restriction in EP children persists into school age.
- Catch-up growth partially mitigates early deficits, most notably in head growth.
- Despite growth restriction, blood pressure in EP children was similar to term-born classmates.
Background:
Preterm children are at risk for reduced growth in early childhood, which may predispose them to later changes in blood pressure (BP).
Objective:
To study growth and BP in extremely preterm (EP) children at age 6 years.
Methods:
Children who were born at 25 completed weeks of gestation or less in the United Kingdom and Ireland in 1995 were evaluated when they reached early school age. Children underwent standardised assessments, including auxology and sitting BP.
Results:
Of 308 surviving children, 241 (78%) were assessed at a median age of 6 years 4 months; 160 full-term classmates acted as a comparison group. Compared with classmates, EP children were 1.2 standard deviations (SDs) lighter, 0.97 SD shorter, body mass index (BMI) was 0.95 SD lower and head circumference 1.3 SD lower. Compared with 2.5 years of age, EP children had shown "catch-up" in their weight by 0.37 SD, height by 0.42 SD and head circumference by 0.13 SD. Systolic and diastolic BP were lower by 2.3 mm Hg and 2.4 mm Hg, respectively, in EP children, but these differences were accounted for by differences in height and BMI. Maternal smoking in pregnancy was associated with lower BP. Children born before 24 weeks had higher systolic pressures and children given postnatal steroids higher diastolic pressures.
Conclusions:
Poor postnatal growth seen after birth and in the third year persists into school age. Catch-up growth reduces some of the early deficit but is least for head growth. Despite serious postnatal growth restriction BP appears similar in both EP and term classmates.
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