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Catch-up growth during childhood among very low-birth-weight children
M Hack1, B Weissman, E Borawski-Clark
1Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, USA.
Insights
Very low-birth-weight (VLBW) children demonstrate significant catch-up growth throughout childhood, reaching normal growth percentiles by age 8. However, small-for-gestational-age VLBW infants show slower catch-up growth rates.
Area of Science:
- Pediatric Growth and Development
- Neonatal Research
- Longitudinal Cohort Studies
Background:
- Very low-birth-weight (VLBW) infants often experience growth deficits.
- Understanding catch-up growth is crucial for long-term health outcomes.
- Comparison with normal-birth-weight (NBW) peers provides essential benchmarks.
Purpose of the Study:
- To assess growth attainment in VLBW children up to 8 years of age.
- To identify factors influencing catch-up growth in VLBW populations.
- To compare growth trajectories of VLBW and NBW children.
Main Methods:
- Longitudinal follow-up of 249 VLBW children and 363 NBW children over 8 years.
- Data collected at birth, 40 weeks, 8 months, 20 months, and 8 years.
- Growth parameters (weight, height) compared against National Center for Health Statistics standards.
Main Results:
- Significant catch-up growth observed in VLBW children, with subnormal growth decreasing from 54% at 40 weeks to 8% at 8 years.
- Small-for-gestational-age (SGA) VLBW children exhibited slower catch-up growth.
- Maternal height, race, birth weight, and neurologic abnormalities predicted height percentile distribution.
Conclusions:
- Catch-up growth is a significant phenomenon in VLBW children during childhood.
- These findings are vital for parental counseling regarding growth potential.
- Early growth deficits in VLBW infants can be overcome, but SGA status warrants closer monitoring.
Objectives:
To examine growth attainment and correlates of catch-up growth at 8 years of age in a cohort of very low-birth-weight (VLBW) children (< 1500 g), including appropriate and small-for-gestational-age children, and to compare their growth with normal-birth-weight (NBW) children.
Design:
Eight-year longitudinal follow-up of a cohort of VLBW children. A geographically based, randomly selected sample of NBW children was recruited at 8 years of age.
Setting:
Tertiary perinatal center.
Participants:
Two hundred forty-nine VLBW children born between January 1, 1977, and December 31, 1979 (78% of survivors), of whom 199 were born appropriate for gestational age and 50 were small for gestational age (< -2 SD). The NBW population included 363 children.
Main Outcome Measures:
For the VLBW population, rates of subnormal weight (below the third percentile) and height were obtained at birth, at 40 weeks (term), and at 8 and 20 months. For the VLBW and NBW populations, mean weight, height, and percentile distribution at 8 years were derived from the National Center for Health Statistics standards.
Results:
Catch-up growth to above the third percentile occurred between 40 weeks and 8 months, 8 and 20 months, and up to 8 years of age among the VLBW children. At 40 weeks, 54% were subnormal in weight and 60% were subnormal in height; at 8 months, 33% and 22%, respectively, and at 8 years, 8% were subnormal in weight and height. Small-for-gestational-age children had lower rates of catch-up growth. Multivariate analyses disclosed maternal height, race, birth weight, and neurologic abnormality to predict percentile distribution of height; and maternal height, small for gestational age, and neurologic abnormality to predict subnormal height.
Conclusions:
Catch-up growth occurs during childhood among VLBW children. These results have implications when counseling parents about the potential growth attainment of their children.