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Updated: Aug 20, 2026

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Postnatal Growth Patterns in Children Born at Term and Preterm in a Large Primary Care Network

Allison C Lure1, Eleanor Verhagen2, Emily Trudell Correa2

  • 1Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, MA.

The Journal of Pediatrics
|August 18, 2026
PubMed

Insights

Infant growth varies by gestational age, with extremely preterm infants showing incomplete catch-up growth by 36 months. These findings highlight the need to adjust growth monitoring guidelines based on early development.

Area of Science:

  • Pediatric Growth and Development
  • Neonatal Medicine
  • Public Health

Background:

  • Infant and toddler growth trajectories are influenced by gestational age.
  • Current growth monitoring guidelines may not fully account for variations in preterm infant development.

Purpose of the Study:

  • To analyze longitudinal growth patterns in infants and toddlers up to 36 months of age, stratified by gestational age.
  • To identify differences in growth metrics and catch-up growth among various preterm and term infant groups.

Main Methods:

  • Retrospective cohort study of 60,966 children from a Massachusetts primary care network (2017-2023).
  • Analysis of 1,545,254 growth measurements converted to z-scores at standardized intervals.
  • Assessment of time to surpass the -2 z-score threshold for weight and height.

Main Results:

  • Preterm infants exhibited lower z-scores at birth compared to term infants, with differences correlating to gestational age.
  • Growth parameters for preterm infants generally approached those of term infants over time.
  • By 36 months, less than 95% of extremely preterm infants reached the -2 z-score threshold for weight and height, unlike moderate/late preterm infants by 24 months.

Conclusions:

  • Gestational age significantly impacts infant and toddler growth through 36 months.
  • Incomplete catch-up growth was observed in infants born at the earliest gestational ages.
  • Recommendations include adjusting growth monitoring for infants born before 32 weeks gestation through 36 months and those born between 32-37 weeks through 24 months.
Abstract

Keywords:
-upNICU followgrowthprematurity

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