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Longitudinal follow-up of growth in children born small for gestational age
K Albertsson-Wikland1, G Wennergren, M Wennergren
1Department of Paediatrics I, University of Göteborg, Sweden.
Insights
Most small-for-gestational-age (SGA) boys achieve catch-up growth by three months, while girls show a more gradual catch-up by four years. This study tracked postnatal growth in 123 SGA children to assess growth patterns.
Area of Science:
- Pediatrics
- Human Growth and Development
- Neonatology
Background:
- Small-for-gestational-age (SGA) infants are at increased risk for growth abnormalities.
- Accurate assessment of gestational age is crucial for distinguishing SGA from preterm infants.
- Exclusion criteria were applied to ensure a homogenous study population, focusing on idiopathic SGA.
Purpose of the Study:
- To determine the incidence and timing of postnatal catch-up growth in small-for-gestational-age (SGA) children.
- To compare catch-up growth patterns between boys and girls up to four years of age.
- To evaluate the long-term growth trajectory of SGA infants without identifiable causes for growth restriction.
Main Methods:
- A population-based cohort of 123 small-for-gestational-age (SGA) children (birth weight < -2 SD) was followed for four years.
- Gestational age was precisely determined by ultrasound at 16-17 weeks to differentiate SGA from preterm infants.
- Infants with known causes of growth restriction (chromosomal, malformations, infections, cerebral palsy) were excluded.
Main Results:
- Boys exhibited rapid weight catch-up, with 85% reaching > -2 SD by three months and maintaining it.
- Two-thirds of girls achieved rapid weight catch-up, with 85% above -2 SD by four years.
- Length catch-up was slower; at four years, only 11% of boys and 5% of girls remained below -2 SD for length.
Conclusions:
- Small-for-gestational-age (SGA) boys demonstrate significantly faster weight catch-up growth compared to girls.
- While most SGA children achieve catch-up growth by four years, length gain is more protracted.
- The findings highlight sex-specific differences in postnatal growth trajectories for SGA infants.
Abstract:
Postnatal growth was followed in a population-based group of 123 small-for-gestational-age (SGA, birth weight < -2 SD) children (66 boys and 57 girls) to four years of age in order to determine the incidence and time of catch-up growth. Gestational age was determined by ultrasound in gestational weeks 16-17 in all pregnancies, thus eliminating the problem of distinguishing between SGA and preterm infants. Infants with well-defined causes for slow growth rate, i.e. those infants with chromosomal disorders, severe malformations, intrauterine viral infections or cerebral palsy, were excluded. The boys showed an extremely fast weight catch-up, 85% of them reaching weights greater than -2 SD at the age of three months and remaining above this level to the end of the study period. Such a fast catch-up growth was observed in only two-thirds of the girls, but at four years of age 85% of the girls were also above -2 SD. Length catch-up was more gradual than weight catch-up. Of the boys, 54% had lengths below -2 SD at birth, 26% at 1 year of age, 22% at 2 years of age, 17% at 2.5 years of age and 11% (n = 8) at 4 years of age. Corresponding figures for girls were: 69% at birth, 28% at 1 year, 15% at 2 years, 12% at 2.5 years and 5% (n = 3) at 4 years. At 4 years of age, only six boys and three girls remained below -2 SD for both weight and height.(ABSTRACT TRUNCATED AT 250 WORDS)