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Growth charts and long-term sequelae in extreme preterm infants--from full-term age to 10 years
Eva Horemuzova1, Per Amark, Lena Jacobson
1Paediatric Endocrinology Unit, Department for Women's and Children's Health, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden. eva.horemuzova@ki.se.
Insights
Growth patterns in extremely preterm infants show catch-up growth by age 10, reaching genetic potential for height. However, nearly half of these children experienced significant long-term sequelae.
Area of Science:
- Neonatalogy
- Pediatric Growth and Development
- Perinatal Medicine
Background:
- Infants born before 26 weeks gestation are at high risk for growth deficits.
- Understanding their long-term growth trajectory is crucial for clinical management.
Purpose of the Study:
- To describe the growth pattern from term-equivalent age to 10 years in infants born extremely preterm.
- To assess attained growth in relation to genetic potential.
Main Methods:
- Retrospective longitudinal cohort study of 123 children born before 26 weeks gestation.
- Monthly measurements of length/height (Ht), weight (Wt), and head circumference (HC) during the first year, with subsequent measurements up to 10 years.
- Z-scores calculated to compare growth against reference data.
Main Results:
- At term, infants showed significant deficits in Ht (Z-scores -3.8/-3.1), Wt (-3.0/-2.5), and HC (-1.7/-1.2).
- By 10 years, mean Ht Z-scores improved to -0.7/-0.4, aligning with mid-parental height, and Wt Z-scores to -0.2/-0.2.
- Long-term sequelae were observed in 48% of boys and 34% of girls.
Conclusions:
- Extremely preterm infants demonstrate significant catch-up growth by 10 years, achieving growth aligned with their genetic potential.
- Despite catch-up growth, a substantial proportion of these children experience long-term sequelae.
Aim:
To describe growth pattern from full-term age to 10 years in infants born before 26 weeks of gestation.
Method:
This retrospective longitudinal cohort contained 123 children from Karolinska Hospital, Stockholm, during 1990-2002. Length/height (Ht), weight (Wt) and head circumference (HC) were recorded monthly during the first year, every 3 months until 2 years and yearly thereafter, but HC at 15 months and at median age of 8.1/9.7 years (range 2-14) in boys/girls.
Results:
For boys/girls at birth, the mean Z-score for Ht was -0.2/-0.2, for Wt 0.0/-0.2 and for HC 0.0/-0.3. At term, the mean Z-score for Ht was -3.8/-3.1, for Wt -3.0/-2.5 and for HC -1.7/-1.2. At 1 year, the mean Z-score for Ht was-1.3/-1.3, for Wt -1.9/-1.7 and for HC -1.2/-1.0. At 2 years, the mean Z-score for Ht was -1.3/-1.1, for Wt -1.6/-1.2 and at 10 years for Ht -0.7/-0.4; that was on average -0.3 below mid-parental height; for Wt -0.2/-0.2. Long-term sequelae were found in 48% of the boys and 34% of the girls.
Conclusion:
By 10 years of age, the attained mean Ht was in accordance with their genetic potential and almost half of these children had significant long-term sequelae.
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