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Effects of prematurity and dysmaturity on growth at age 5 years
Insights
Children small for gestational age (SGA) show reduced growth compared to appropriate for gestational age (AGA) peers. Perinatal factors significantly impact SGA children
Area of Science:
- Pediatric Growth and Development
- Neonatal Health
- Childhood Nutrition
Background:
- Intrauterine growth restriction (IUGR) impacts long-term child development.
- Understanding factors influencing growth from birth to age 5 is crucial.
Purpose of the Study:
- To investigate the long-term growth patterns of children born small for gestational age (SGA) versus appropriate for gestational age (AGA).
- To determine the influence of parental and perinatal factors on childhood growth up to age 5.
Main Methods:
- Longitudinal observation of term and preterm AGA and SGA children from birth to 5 years.
- Measurement of parental anthropometrics (height, weight) in a subset of families.
- Statistical analysis, including multivariate analysis, to assess growth determinants.
Main Results:
- SGA children exhibited a significantly higher prevalence of short stature (17%) compared to AGA children (3.4%).
- Preterm SGA infants showed reduced growth, suggesting early in-utero growth failure impacts postnatal development.
- Term SGA infants had a higher incidence of microcephaly, indicating late-in-utero growth impairment affects head growth.
- Child height at age 5 correlated with parental height in AGA children, but with birth length in SGA children.
- Child weight at age 5 correlated with maternal weight only in AGA children.
- Multivariate analysis confirmed parental factors influence AGA children's growth, while perinatal factors are more significant for SGA children.
Conclusions:
- Early and late intrauterine growth restriction significantly impacts childhood growth trajectories.
- Genetic (parental) factors play a more dominant role in the growth of appropriate for gestational age children.
- Perinatal factors are more influential in determining the growth outcomes of small for gestational age children.
Abstract:
Forty-two term and 106 preterm appropriate for gestational age (AGA), and 43 term and 31 preterm small for gestational age (SGA) children were observed from birth to age 5 years. Parents' weight and height were also measured in 193 subjects including 97 couples. The percentage of short children was higher in SGA (17%) than in AGA (3.4%) children (P less than 0.01). This difference was significant in the preterm but not in the term children, suggesting that early failure of growth in utero can result in reduced growth in children. The findings were similar for weight and head circumference, but microcephaly was more frequent in term SGA (30%) than in preterm SGA (6.4%) children (P less than 0.05), suggesting that late impaired growth in utero can result in poor growth of the head. Height at the age of 5 years correlated with the parents' height only in AGA children, and with length at birth in SGA children. Weight of the 5-year-old children correlated with the mother's weight only in AGA children. Multivariate analysis in 66 couples and their children confirmed a greater tendency toward the influence of parental factors in AGA children and a more significant relationship with perinatal factors in SGA children.