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Growth throughout childhood of children born growth restricted
Fenny Beukers1, Joost Rotteveel2, Mirjam M van Weissenbruch2
1Department of Paediatrics, Academic Medical Center, Amsterdam, The Netherlands.
Insights
Children born with fetal growth restriction (FGR) show normal height and BMI by age 12.5 years, regardless of FGR severity. These findings differ from studies on small for gestational age (SGA) children.
Area of Science:
- Pediatrics
- Neonatology
- Obstetrics
Background:
- Fetal growth restriction (FGR) and small for gestational age (SGA) are distinct conditions affecting newborn growth.
- Previous studies often group FGR and SGA, leading to unclear growth outcomes for FGR.
- Postnatal growth patterns in children with FGR due to early placental insufficiency require further investigation.
Purpose of the Study:
- To investigate the long-term postnatal growth trajectory until 12.5 years in children born with FGR due to early placental insufficiency.
- To determine the relationship between FGR severity and growth outcomes at 12.5 years.
- To differentiate growth patterns in FGR from those reported in SGA.
Main Methods:
- Prospective cohort study following up on an antenatal randomized controlled trial.
- Inclusion of 96 children aged 12.5 years born with FGR due to severe early-onset hypertensive pregnancy disorders.
- Assessment of anthropometry, including height, body mass index (BMI), and head circumference, using SD scores (SDS).
Main Results:
- At 12.5 years, children exhibited mean height SDS of -0.09 and mean BMI SDS of 0.00, comparable to peers.
- Rapid catch-up growth occurred between term age and 3 months.
- Neither FGR severity nor gestational age correlated with height or BMI at 12.5 years.
Conclusions:
- Children born with FGR due to early placental insufficiency achieve normal height and BMI by 12.5 years.
- FGR severity does not impact long-term height and BMI outcomes.
- These findings offer reassurance and highlight differences compared to SGA growth studies.
Objective:
Many studies that examine growth in growth-restricted children at birth do not discriminate between fetal growth restriction (FGR) and small for gestational age (SGA). These terms however are not synonymous. In SGA, stunting and increased weight gain have been reported. We do not know if this holds true for FGR. Our aim was to study postnatal growth until age 12.5 years in a cohort of children born FGR due to early onset placental insufficiency, and its relation to FGR severity.
Design:
Prospective cohort study, follow-up of an antenatal randomised controlled trial in two tertiary centres.
Patients:
Children aged 12.5 years born after FGR, with mothers who had severe early onset hypertensive pregnancy disorders (N=96).
Main Outcome Measures:
Anthropometry at age 12.5 years in SD scores (SDS).
Results:
Mean height SDS (SD) corrected for target height was -0.09 (0.94), mean body mass index (BMI) SDS was 0.00 (1.16) and mean head circumference SDS was -0.37 (1.11). Catch-up growth was at fastest rate between term age and 3 months and similar for height (0.55 SDS/months) and weight (0.49 SDS/months). Neither FGR severity nor gestational age was related to height and BMI at age 12.5 years.
Conclusions:
Children born growth restricted due to early onset placental insufficiency have height and BMI scores comparable to their age-matched peers at age 12.5 years. FGR severity was not related to height and BMI at age 12.5 years. These reassuring results differ from most studies that examine SGA children.