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Sequelae of growth failure in appropriate for gestational age, very low-birthweight infants
Insights
Very low-birthweight children experienced growth decline post-hospitalization, with some showing persistent low weight at two years. These children faced higher risks of developmental disabilities and health issues, resembling non-organic failure to thrive.
Area of Science:
- Pediatrics
- Neonatology
- Developmental Biology
Background:
- Very low-birthweight (VLBW) infants often exhibit growth deviations.
- Understanding long-term growth patterns is crucial for VLBW child development.
Purpose of the Study:
- To characterize the growth patterns of VLBW infants appropriate for gestational age.
- To identify factors associated with suboptimal growth in VLBW children up to two years corrected age.
Main Methods:
- Longitudinal study of 235 VLBW infants.
- Growth parameters (weight, length, head circumference) tracked from birth to 2 years corrected age.
- Assessment of developmental outcomes using Bayley Scales of Infant Development and maternal-reported data.
Main Results:
- Significant decline in weight, length, and head circumference from birth to discharge, with partial recovery by 2 years corrected age.
- 29% of VLBW children were below the 10th percentile for weight at 2 years.
- Children with suboptimal weight gain exhibited higher rates of major disabilities, poorer motor development, hypotonia, and lower psychomotor scores.
Conclusions:
- Suboptimal weight gain in VLBW children is linked to significant developmental and health challenges.
- Maternal perceptions of 'sickliness' and 'lack of cuddliness' were more frequent in children with poor growth.
- These findings suggest a pattern resembling non-organic failure to thrive in some VLBW infants.
Abstract:
The pattern of growth of 235 very low-birthweight children, whose weights were appropriate for gestational age, was characterised by a significant decline in weight, length and head circumference from birth to discharge from hospital, followed by partial recovery in all three measures of growth by two years corrected age. 29 per cent of the children were below the 10th percentile for weight at two years, and this group had a significantly higher incidence of major disabilities, poorer muscular development, more hypotonia and lowered performance on the psychomotor index of the Bayley Scales of Infant Development than their heavier peers. These children's mothers more often perceived them as actively disliking close physical contact, and they were reported by their mothers to have had more infections, minor surgery and chronic otitis media. Taken together, the suboptimal weight-gain, delayed gross motor development and increased maternal perceptions of 'sickliness' and lack of 'cuddliness' in these children are reminiscent of non-organic failure to thrive.