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Predictive factors of catch-up growth in term, small for gestational age infants: a two-year prospective
Fadila Bouferoua1, Mohamed El Mokhtar Khiari1, Nafissa Benhalla1
1Pediatric Department "A", Beni Messous Hospital, Algiers, Algeria.
Insights
Most small for gestational age (SGA) infants achieve catch-up growth. However, 12.1% of term SGA infants in Algeria did not achieve catch-up growth by 2 years, indicating a need for continued monitoring and potential growth-promoting treatment.
Area of Science:
- Pediatrics
- Neonatology
- Endocrinology
Background:
- Most infants born small for gestational age (SGA) experience catch-up growth.
- A minority of SGA infants fail to achieve adequate growth, potentially benefiting from interventions.
- Identifying risk factors for failed catch-up growth is crucial for targeted management.
Purpose of the Study:
- To determine the prevalence of failure to achieve catch-up growth in term SGA infants.
- To identify risk factors associated with the lack of catch-up growth in this population.
- To inform potential growth-promoting treatment strategies and national follow-up programs.
Main Methods:
- Prospective observational study of term infants (37-42 weeks gestation) with birth weight below the 10th percentile.
- Measurements of length, weight, and head circumference from birth to 2 years of age.
- Multivariate analysis to identify independent predictors of failure to show catch-up growth.
Main Results:
- Out of 457 term SGA infants, 12.1% exhibited persistent short stature at 24 months.
- Independent predictors of failed catch-up growth included maternal height <150 cm, significant difference between mid-parental height and birth length, and SGA history.
- Other factors identified were low ponderal index and shorter duration of breastfeeding.
Conclusions:
- This study provides epidemiological data on SGA in Algeria and factors influencing post-natal growth.
- Identifying children with persistent short stature at 2 years allows for targeted follow-up and consideration of growth hormone therapy.
- Results support establishing a national program for SGA infant registration and re-evaluation at 2 years.
Objectives:
Most small for gestational age (SGA) infants show catch-up growth but the minority who do not may benefit from growth-promoting treatment. We determined the prevalence of, and risk factors for, failure to show catch-up growth in term SGA infants.
Methods:
Prospective observational study of infants born at 37-42 weeks gestation between December 2012 and March 2014 with birth weight <10th percentile. Length, weight and head circumference were measured from birth to 2 years.
Results:
Of 457 (3.9 %) term infants with SGA, 446 (97.6 %) were followed up until 2 years. At 24 months, supine length, weight and head circumference were ≥-2 standard deviation score (SDS) in 87.9 , 96.4 and 97.1 % subjects, with persistent short stature in 12.1 %. In a multivariate analysis, the independent predictors of failure to show catch-up growth at 24 months were: maternal height <150 cm, difference between mid-parental height and birth length of ≥2.2 SDS, height at 24 months <-2 SDS below mid-parental height SDS, history of SGA, ponderal index <3rd centile and duration of breast feeding <3 months.
Conclusions:
This study provides data concerning the epidemiology of SGA in Algeria and the factors associated with post-natal growth. Establishing which children remain short at 2 years has identified a cohort of patients requiring continuing follow up, with a view to instituting growth hormone therapy in selected cases. These results favour the setting up of an integrated national program to register SGA infants at birth, with re-evaluation at 2 years. (250 words).
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