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Postnatal growth trajectories of very preterm appropriate-for-gestational-age infants from term-equivalent age to 6

Akinori Moriichi1, Yumi Kono2, Katsuaki Toyoshima3

  • 1Division of Information for Specific Pediatric Chronic Diseases, Research Institute National Center for Child Health and Development, Tokyo, Japan. moriichi-a@ncchd.go.jp.

Pediatric Research
|March 11, 2026
PubMed

Insights

Extremely preterm infants born before 32 weeks of gestation show persistent growth delays into childhood. Those born earlier, especially before 25 weeks, have smaller head sizes, indicating potential neurodevelopmental concerns.

Area of Science:

  • Pediatrics
  • Neonatology
  • Growth and Development

Background:

  • Very preterm infants (<32 weeks gestation) are prone to postnatal growth impairment.
  • Limited longitudinal data exists for appropriate-for-gestational-age (AGA) preterm infants.
  • Standard growth references may not accurately represent preterm infant development.

Purpose of the Study:

  • To establish sex-specific growth curves for AGA infants born extremely preterm (<32 weeks gestation).
  • To compare the growth trajectories of these infants with national growth standards.
  • To identify potential long-term growth deficits and neurodevelopmental implications.

Main Methods:

  • Constructed growth curves (height, weight, BMI, head circumference) from term-equivalent age to 6 years.
  • Included AGA infants born <32 weeks gestation without neurodevelopmental impairments.
  • Compared developed trajectories with Japanese national growth standards.

Main Results:

  • Infants born before 28 weeks showed significantly reduced growth compared to national standards, peaking between 40-60 weeks postmenstrual age.
  • Catch-up growth was gradual but did not fully align with standard curves.
  • Lower gestational age correlated with greater growth deficits; head circumference was notably reduced in infants born before 25 weeks.

Conclusions:

  • Extremely preterm AGA infants experience persistent growth deficits throughout early childhood.
  • Long-term growth surveillance and early interventions are crucial for optimizing outcomes.
  • Smaller head circumference in the earliest preterm infants raises concerns for neurodevelopmental outcomes.
Abstract

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