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Childhood Health Outcomes in Term, Large-for-Gestational-Age Babies With Different Postnatal Growth Patterns
Xiaoping Lei1,2, Dongying Zhao1, Lisu Huang1
1Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
Insights
Large-for-gestational-age (LGA) infants with small catch-down growth show no increased risk of adverse childhood health outcomes. Other growth patterns in term LGA babies are linked to higher risks of obesity, growth restriction, low IQ, and high blood pressure.
Area of Science:
- Pediatrics
- Neonatology
- Public Health
Background:
- Large-for-gestational-age (LGA) infants face elevated risks for later-life metabolic diseases.
- Postnatal growth patterns in early childhood may influence long-term health outcomes for LGA infants.
- Understanding these associations is crucial for early intervention and improved pediatric health.
Purpose of the Study:
- To investigate the childhood health outcomes of term LGA infants based on their postnatal growth trajectories.
- To identify specific growth patterns associated with adverse health outcomes such as obesity, growth restriction, low IQ, and high blood pressure (HBP).
- To compare these outcomes with those of term appropriate-for-gestational-age infants.
Main Methods:
- Utilized data from the US Collaborative Perinatal Project (1959-1976).
- Identified growth trajectories for 3,316 term LGA infants.
- Employed logistic regression to calculate odds ratios for obesity, growth restriction, low IQ, and HBP.
Main Results:
- Term LGA babies without catch-down growth exhibited significantly higher risks of obesity (aOR=6.37) and HBP (aOR=1.67).
- Those with high catch-down growth showed increased risks for growth restriction (aOR=2.21) and low IQ (aOR=1.61).
- Infants with small catch-down growth demonstrated reduced risks for obesity (aOR=0.78), growth restriction (aOR=0.28), and HBP (aOR=0.89), with no significant increase in low IQ risk (aOR=0.66).
Conclusions:
- Term LGA infants experiencing small catch-down growth do not present increased risks for adverse childhood health outcomes.
- Specific postnatal growth patterns significantly influence the long-term health trajectory of LGA infants.
- Targeted monitoring and interventions for LGA infants based on their growth patterns are warranted.
Abstract:
Large-for-gestational-age (LGA) babies have a higher risk of metabolic disease later in life, and their postnatal growth in early childhood may be associated with long-term adverse outcomes. This study aimed to determine childhood health outcomes of term LGA babies with different growth patterns. Data were obtained from the US Collaborative Perinatal Project for the years between 1959 and 1976. The growth trajectories of 3,316 term LGA babies were identified and odds ratios of obesity, growth restriction, low intelligence quotient (IQ), and high blood pressure (HBP) were calculated by logistic regression. Compared with term appropriate-for-gestational-age infants, term LGA babies without catch-down growth had increased risks of obesity (adjusted odds ratio (aOR) = 6.37, 95% confidence interval (CI): 5.24, 7.73) and HBP (aOR = 1.67, 95% CI: 1.37, 2.03). Those with high catch-down growth had higher risks of growth restriction (aOR = 2.21, 95% CI: 1.66, 2.95) and low IQ (aOR = 1.61, 95% CI: 1.04, 2.49). Nevertheless, infants with small catch-down growth had lower risks of obesity (aOR = 0.78, 95% CI: 0.63, 0.95), growth restriction (aOR = 0.28, 95% CI: 0.17, 0.46), low IQ (aOR = 0.66, 95% CI: 0.41, 1.06), and HBP (aOR = 0.89, 95% CI: 0.77, 1.04). According to our data, term LGA infants with small catch-down growth had no increased risks of adverse outcomes.