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Birth Weight Percentiles and Infant and Child Growth Dynamics.
María Alejandra Hernandez1,2, Richard M A Parker1,2, Tim J Cole3
1MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom.
JAMA Network Open
|July 8, 2026
Summary
Birth weight percentiles significantly influence infant growth patterns, affecting height, weight, and BMI trajectories. Utilizing birth weight deciles may identify at-risk infants missed by conventional measures, though benefits are modest.
Area of Science:
- Pediatric growth and development
- Perinatal epidemiology
- Childhood obesity risk factors
Background:
- Infants small or large for gestational age exhibit distinct growth patterns.
- The association between extreme birth weight percentiles and early-life growth is not well understood.
Purpose of the Study:
- To quantify the relationship between birth weight percentile ranges and infant/child growth trajectories.
- To assess the predictive value of birth weight percentiles for long-term growth outcomes.
Main Methods:
- Prospective cohort study involving 7 international birth cohorts (1991-2011).
- Standardized birth weight percentiles (INTERGROWTH-21st) classified into 10 deciles.
- Growth velocity, BMI, BMI rebound, and overweight/obesity at 10 years were primary outcomes.
Main Results:
- Higher birth weight deciles correlated with earlier BMI peaks, higher BMI rebound, and increased risk of childhood overweight/obesity.
- Lower birth weight deciles showed inverse growth patterns.
- Associations were generally linear and consistent between sexes, with modest gains over traditional categories.
Conclusions:
- Birth weight deciles are associated with distinct early-life growth patterns.
- Birth weight percentiles beyond conventional thresholds can identify high-risk infants.
- The incremental benefit of using deciles over traditional categories for risk identification is modest.
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