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Growth of extremely preterm survivors from birth to 18 years of age compared with term controls
Gehan Roberts1, Jeanie Cheong, Gillian Opie
1Centre for Community Child Health, The Royal Children's Hospital, Flemington Rd, Parkville, 3052, Australia. gehan.roberts@rch.org.au
Insights
Extremely preterm survivors show persistent height deficits and decreasing weight differences compared to term-born peers by age 18. While initially lighter, their body mass index (BMI) becomes similar to controls by late adolescence.
Area of Science:
- Pediatrics
- Neonatology
- Growth and Development
Background:
- Extremely preterm (EPT) infants born before 28 weeks gestation face long-term health challenges.
- Understanding growth trajectories in EPT survivors is crucial for monitoring and intervention.
Purpose of the Study:
- To compare the growth (height, weight, BMI) of extremely preterm survivors with term-born controls from birth to 18 years.
- To identify predictors of final height in EPT survivors.
Main Methods:
- Longitudinal study of EPT survivors and term controls born in Victoria, Australia (1991-1992).
- Measurements of height, weight, and BMI collected at birth, discharge, and ages 2, 5, 8, and 18 years.
- Statistical comparison of z scores between groups; analysis of height predictors.
Main Results:
- EPT survivors were lighter at birth and discharge, with weight differences decreasing over time.
- EPT children were consistently shorter than controls, with this height deficit remaining stable.
- BMI z scores were lower in EPT children initially but similar to controls by age 18.
- Early childhood height (age 2) predicted adult height better than parental height in EPT survivors.
Conclusions:
- Extremely preterm survivors experience persistent height disadvantages and decreasing weight deficits into late adolescence.
- While weight gaps narrow, height differences remain constant, indicating long-term growth impacts.
- BMI normalization by age 18 suggests catch-up growth in adiposity for EPT survivors.
Objectives:
To determine changes in height, weight, and BMI of extremely preterm (EPT; gestational age <28 completed weeks) survivors from birth to 18 years of age, compared with term controls.
Methods:
Birth, discharge, and follow-up at ages 2, 5, 8, and 18 years of consecutive EPT survivors and contemporaneous term controls born in 1991-1992 in Victoria, Australia. Weight, height, and BMI were converted to z scores and compared between groups. Height z scores at age 2 and midparental height z scores were examined as predictors of height z score at age 18 years.
Results:
Follow-up rates were >90% until 18 years, when 166 (74%) of 225 EPT subjects and 153 (60%) of 253 controls were assessed. EPT subjects had lower weight z scores than controls at birth, with a much greater difference at discharge, which reduced progressively until age 18 years. EPT children were shorter than controls at all ages, and this difference did not alter greatly over time. BMI z scores were lower in EPT children at younger ages, but by age 18 were similar between groups. Height at age 2 was a better predictor of height at age 18 in EPT participants, compared with midparental height.
Conclusions:
EPT survivors were substantially lighter than term controls from birth to late adolescence, although the gap in weight steadily decreased over time from a peak at the time of discharge. The height disadvantage in EPT children compared with controls remained constant over time and BMI scores were similar at age 18 years.
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