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"Catch-up" following severe intrauterine retardation of head growth
Insights
Preterm infants with intrauterine growth restriction can achieve significant head size catch-up growth. Neonatal nutrition did not influence this head growth trajectory in the first year of life.
Area of Science:
- Neonatology
- Pediatric Growth and Development
- Fetal Medicine
Background:
- Intrauterine growth restriction (IUGR) can affect head circumference in preterm infants.
- Understanding catch-up growth potential is crucial for long-term neurodevelopmental outcomes.
- The role of neonatal nutrition in head growth recovery requires further investigation.
Purpose of the Study:
- To evaluate the potential for head circumference catch-up growth in preterm infants with severe intrauterine head growth retardation.
- To determine the influence of neonatal nutrition on head growth in these infants during the first year of life.
Main Methods:
- Retrospective analysis of head growth in 18 preterm infants (born before 34 weeks gestation) with severe IUGR.
- Assessment of head circumference from birth up to 10 months post-term.
- Examination of correlations between neonatal protein and calorie intake and head growth patterns.
Main Results:
- Most infants (17/18) demonstrated significant head circumference catch-up growth by 10 months post-term.
- Eight infants achieved head circumference on or above the 50th percentile.
- Neonatal protein and calorie intake did not significantly impact catch-up head growth.
Conclusions:
- Severe intrauterine head growth retardation in otherwise normal preterm infants is likely due to extrinsic factors, not intrinsic fetal growth potential.
- Head size catch-up is a common phenomenon in this population.
- Neonatal nutritional interventions did not appear to modulate head growth recovery in the first year.
Abstract:
In order to assess the potential for "catch-up" growth of the head in "symmetrically" growth retarded infants and the influence of neonatal nutrition, head growth over the first year of life in 18 preterm infants with severe intra-uterine retardation of head growth, but who were otherwise normal, was examined retrospectively. All were delivered before 34 weeks of gestation and, except for 1 with cerebral palsy, showed a significant "catch-up" in head circumference by 10 months post term, with 8/18 stabilizing on or above the fiftieth centile (Fig. 1). This suggests that the reduction in head size in such infants is due to factors extrinsic to the fetus, rather than to a reduced fetal growth potential. Differences in protein and calorie intakes in the neonatal period did not appear to influence the "catch-up".