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Growth in the first four years: II. Diversity within groups of small-for-dates and large-for-dates babies
Insights
Infants born small-for-dates (SFD) or large-for-dates (LFD) showed significant growth shifts toward average-for-dates (AFD) in the first six months. Most children approached average growth by age four, though some remained at extremes.
Area of Science:
- Pediatrics
- Human Growth and Development
- Child Health
Background:
- Infant growth patterns vary significantly at birth, with categories including small-for-dates (SFD), average-for-dates (AFD), and large-for-dates (LFD).
- Understanding long-term growth trajectories for infants at the extremes of birth weight is crucial for identifying potential developmental issues.
Purpose of the Study:
- To track the growth trajectories of small-for-dates (SFD) and large-for-dates (LFD) infants from birth to four years.
- To compare the growth patterns of SFD and LFD infants with average-for-dates (AFD) infants.
Main Methods:
- Longitudinal study involving personal examinations and home measurements of weight, length/height, and head circumference.
- Data collected at birth and at 2, 6, 12, 18 months, and 2, 3, 4 years for SFD, AFD, and LFD infant groups.
- Statistical analysis to assess shifts towards the mean and correlations between measurements over time.
Main Results:
- Both SFD and LFD infants exhibited major shifts towards the AFD mean in the first six months for weight, length, and head circumference.
- Growth fluctuations were minimal from one year onwards, with high correlations between one and four-year measurements.
- At four years, approximately 50% of SFD children were within 1 SD of the mean, while 55-60% of LFD children were near the mean, especially for head circumference (70%).
Conclusions:
- Most infants born small or large for gestational age demonstrate significant catch-up or regression towards average growth by early childhood.
- While most extreme groups normalize, a proportion of SFD infants remain small and a small percentage of LFD infants remain large at four years.
- Individual growth trajectories highlight considerable diversity within and between SFD and LFD groups, emphasizing the need for personalized monitoring.
Abstract:
238 small-for-dates (SFD), 246 average-for-dates (AFD) and 241 large-for-dates (LFD) infants were personally examined at birth, and measured thereafter in their own homes at the ages of 2, 6, 12 and 18 months, 2, 3 and 4 years. At each age weight, length or height, and head circumference measures in the SFD and LFD groups were distributed around the appropriate sex AFD mean values. In both extreme groups major shifts towards the mean occurred in the first six months for all three measures. From one year onwards only small within group fluctuations were seen. Correlations between one and four year values for weight, height and head circumference were high. At four years about 50% SFD children were within 1 S.D. of the mean, and 10% were still very small. Slightly more LFD children (55-60%) were near to the mean at this age, particularly for their head circumference values (70%), and only about 8% LFD children had very large heads. Trajectories of individual SFD and LFD children illustrate the great diversity of growth patterns within and between groups.