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Published on: November 20, 2015
Growth and development in preterm infants small for gestational age
Insights
Preterm infants small for gestational age (SGA) showed catch-up growth and comparable neurodevelopment by age 5, highlighting the need for long-term infant follow-up for optimal outcomes.
Area of Science:
- Neonatalogy and Developmental Pediatrics
- Perinatal Health and Growth Monitoring
Background:
- Preterm infants small for gestational age (SGA) and appropriate for gestational age (AGA) present distinct growth and developmental trajectories.
- Understanding long-term outcomes is crucial for optimizing care for these vulnerable populations.
Purpose of the Study:
- To prospectively compare the growth patterns, neurologic, and developmental performance of preterm SGA and AGA infants up to 5 years of age.
- To identify factors influencing developmental outcomes in preterm infants.
Main Methods:
- A prospective study of 21 preterm SGA and 20 preterm AGA infants (birth weight < 1500 gm), excluding those with anomalies.
- Follow-up evaluations of growth, neurologic status, and developmental performance were conducted until 5 years of age.
- Linear regression analysis was used to assess the relationship between socioeconomic status and developmental outcome.
Main Results:
- While SGA infants' weights and lengths were comparable to AGA infants at 1 year, AGA infants were significantly heavier and taller from 2 to 5 years.
- Major neurologic abnormalities were comparable (15% SGA vs. 12% AGA), but minor abnormalities were more frequent in SGA infants (26% vs. 12%).
- SGA infants scored lower in development at 9 months to 3 years, but this difference disappeared by 4 to 5 years; socioeconomic status positively correlated with development.
Conclusions:
- Preterm SGA infants demonstrate catch-up growth and developmental performance comparable to AGA peers by 5 years of age.
- Minor neurologic abnormalities are more common in SGA infants, warranting continued monitoring.
- Long-term follow-up is essential for assessing the full developmental trajectory and outcomes of preterm infants.
Abstract:
The growth pattern and neurologic and developmental performance of 21 preterm infants small for gestational age and 20 preterm infants appropriate for gestational age (birth weight less than 1500 gm) were prospectively studied. The two groups had comparable birth weight, sex, perinatal morbidities, and socioeconomic status. All infants with congenital anomalies or genetic defects were excluded. Nineteen of 21 SGA (90%) and 16 of 20 AGA (80%) infants born in 1975 or 1976 were evaluated in our follow-up program until 5 years of age. At 1 year of age, the weights and lengths of the SGA infants were comparable to those of their AGA counterparts; AGA infants were significantly heavier, however, at 2, 3, 4, and 5 years of age. In addition, AGA infants were significantly taller at 2, 3, and 5 years. Neurologic evaluation of 5 years showed a comparable rate of major abnormalities between the SGA (15%) and AGA (12%) children. Minor neurologic abnormalities were present in 26% of SGA and 12% of AGA children. Linear-regression analysis demonstrated a positive relationship between socioeconomic status and developmental outcome for both SGA and AGA children at 5 years of age. Although SGA infants scored significantly lower in developmental performance at 9 months through 3 years of age, at 4 to 5 years of age this difference was no longer observed. These observations indicate the importance of long-term follow-up.
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