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Long-term growth in small-for-date children
1Department of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.
Insights
Infants with intrauterine growth retardation (IUGR) show initial catch-up growth, but many remain small. Preterm infants with IUGR face higher mortality and persistent growth deficits by 18 months.
Area of Science:
- Pediatrics
- Neonatology
- Growth and Development
Background:
- Intrauterine growth retardation (IUGR) affects fetal development.
- Understanding long-term growth patterns in IUGR infants is crucial.
Purpose of the Study:
- To analyze the growth trajectories of infants with significant IUGR during the first two years of life.
- To compare growth outcomes between term and preterm infants with IUGR.
Main Methods:
- Longitudinal study of 158 infants with IUGR.
- Data collection on weight and height for the first 24 months.
- Analysis of growth acceleration, catch-up potential, and percentile attainment.
Main Results:
- Term IUGR infants showed early weight and linear catch-up growth, but 29% remained below the 5th percentile by 2 years.
- Preterm IUGR infants had 18% mortality, with 44% below the 5th percentile for weight at 18 months post-term.
- Catch-up growth potential in preterm infants extended to 9 months post-term.
Conclusions:
- While catch-up growth occurs, a significant proportion of IUGR infants, especially preterm, experience persistent growth deficits.
- Neonatal factors and gestational age influence long-term growth outcomes in IUGR populations.
Abstract:
The growth patterns of 158 infants with significant intrauterine growth retardation (IUGR) were studied for the first 2 years of life. Eighty-four infants were born after 36 completed weeks. All these full-term infants survived; complete follow-up data were obtained for 78. Acceleration of growth in weight began soon after birth and continued for an average of 6 months. Acceleration of linear growth began somewhat later, but was limited to the first 9 months. Twenty-three infants (29%) were still below the 5th centile for both weight and height by 2 years of age. There was a negative correlation between the neonatal ponderal index and length at 18 months for females only. Seventy-four infants were born prematurely, before 37 weeks' gestation. Mortality in this group was 18% and complete follow-up data were obtained for 49 of the 61 survivors. Birth weight was regained on average at 11 days; accelerated weight velocity began 4-6 weeks before the expected date of delivery (term date). The potential for catch-up growth lasted up to 9 months after the term date. By 18 months, however, 44% of these pre-term infants were still below the 5th centile for weight. Size at 18 months post-term was correlated with weight at the term date and length at 3 months post-term, but not with the degree of IUGR or with the ponderal index.