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Growth patterns for infants weighing less than 801 grams at birth to 3 years of age
D K Daily1, H W Kilbride, R Wheeler
1Department of Pediatrics, Children's Mercy Hospital, University of Missouri-Kansas City.
Insights
Extremely premature infants show initial growth delay but some catch-up growth by 36 months. However, long-term growth deficits, especially in head circumference, persist, similar to prenatal growth retardation.
Area of Science:
- Pediatrics
- Neonatology
- Growth and Development
Background:
- Extremely premature infants (< 801 gm birth weight) experience significant growth challenges.
- Intrauterine growth restriction (IUGR) can have lasting impacts on infant development.
Purpose of the Study:
- To evaluate the longitudinal growth patterns of extremely premature infants from birth to 36 months.
- To assess the long-term effects of premature birth on anthropometric measurements.
Main Methods:
- Monitoring anthropometric measurements (weight, length, head circumference) from birth to 36 months.
- Utilizing standard growth percentiles and Z-score descriptors for growth assessment.
- Statistical analysis to identify predictors of growth outcomes.
Main Results:
- Infants exhibited growth delay at discharge, with partial catch-up growth in the first year.
- Mean length remained below the 5th percentile, and mean weight approximated the 10th percentile at 36 months.
- 45% of infants had head circumference below the 5th percentile at 36 months; low birth weight (< 701 gm) predicted smaller head circumference at 3 years.
Conclusions:
- Extremely premature birth leads to persistent growth deficits, particularly in head circumference, up to 36 months.
- The growth trajectory resembles that of infants with prenatal growth retardation.
- Early anthropometric monitoring is crucial for understanding long-term growth outcomes in this population.
Abstract:
Anthropometric measurements of infants weighing < 801 gm were monitored to evaluate growth patterns from birth to 36 months chronologic age, using both standard growth percentiles and Z score descriptors. Mean gestational age was 25.8 weeks, and birth weight was 708.4 gm. The infants had growth delay at hospital discharge with some catch-up growth occurring in the first year. Discrete changes in body growth using the Z score as a descriptor showed movement from a negative SD at 12 months toward the reference mean of zero at 36 months. However, mean length remained < 5th percentile, and mean weight was at approximately the 10th percentile for chronologic age. At 36 months 45% of infants had a head circumference smaller than the 5th percentile for chronologic age. Birth weight < 701 gm was a significant predictor of smaller occipital-frontal circumference at 3 years (p = 0.03). Interruption of intrauterine growth after extremely premature birth appears to have long-term effects on growth outcome much like prenatal growth retardation.