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Growth and very low birth weight
W H Kitchen1, G W Ford, L W Doyle
1Department of Obstetrics, University of Melbourne, Australia.
Insights
Catch-up growth is unlikely in poorly grown very low birthweight children. Growth centiles at 2 years predict poor growth at 5 years, indicating limited catch-up growth potential.
Area of Science:
- Pediatrics
- Neonatology
- Growth and Development
Background:
- Very low birthweight (VLBW) children often experience growth deficits.
- Limited data exists on catch-up growth potential in VLBW infants.
Purpose of the Study:
- To investigate the likelihood of catch-up growth in VLBW children.
- To identify predictors of sustained poor growth in VLBW children.
Main Methods:
- Longitudinal study tracking weight, height, and head circumference.
- Comparison between VLBW (n=135) and normal birthweight (n=42) children at 2 and 5 years.
- Analysis of growth centiles and incremental growth between 2 and 5 years.
Main Results:
- VLBW children were significantly more likely to be below the 10th centile for weight and height at both 2 and 5 years.
- Children born weighing under 1000g showed poorer weight outcomes at 5 years compared to those weighing 1000-1500g.
- Growth centiles at 2 years were strong predictors of growth status at 5 years; perinatal factors had minimal predictive value.
- VLBW children below the 10th centile for weight or height at 2 years typically remained so at 5 years, showing no catch-up growth.
Conclusions:
- VLBW children exhibit persistent growth deficits, with limited catch-up growth observed by 5 years.
- Early growth assessment at 2 years is crucial for predicting long-term growth outcomes in VLBW populations.
- Interventions targeting VLBW infants should focus on early and sustained growth support.
Abstract:
Information on the likelihood of catch up growth in poorly grown very low birthweight children is sparse. The centiles for weight, height, and head circumference were recorded at both 2 and 5 years of age for 135 very low birthweight children and 42 normal birthweight children. At both ages significantly more children of very low birth weight were under the 10th centile for weight and height. Children of birth weight under 1000 g were more often under the 10th centile for weight at 5 years compared with those of birth weight 1000-1500 g. Mean incremental weight gain between 2 and 5 years was significantly less for very low birthweight children. Mean increment in weight from 2 to 5 years was less for very low birthweight children who had been under the 10th centile for weight at 2 years; children who had been under the 10th centile for height also had lower mean height increments. The growth centiles achieved by 2 years of age were useful predictors of poor growth at 5 years, with perinatal data of marginal importance. Only six of 43 (14%) children with a weight at 5 years of age under the 10th centile were small for gestational age at birth. Very low birthweight children who had a weight or height under the 10th centile at 2 years of age usually remained in this category at 5 years with no evidence of catch up growth.