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The timing of early postnatal catch-up growth in normal, full-term infants born short for gestational age
J P Karlberg1, K Albertsson-Wikland, E Y Kwan
1Department of Paediatrics, Queen Mary Hospital, University of Hong Kong, Hong Kong.
Insights
Infants born small for gestational age (GA) show catch-up growth early in life. Monitoring growth in the first weeks helps predict final height in these infants.
Area of Science:
- Pediatrics
- Human Growth and Development
- Neonatology
Background:
- Infants born small for gestational age (SGA) often experience catch-up growth in early infancy.
- Previous studies suggest this catch-up growth primarily occurs within the first 3-9 months of life.
Purpose of the Study:
- To characterize early postnatal growth patterns in healthy, full-term infants born short for gestational age (< -2 SDS).
- To compare catch-up growth trajectories in Swedish and Hong Kong Chinese populations.
Main Methods:
- Longitudinal growth data from birth to final height for 139 Swedish infants (born 1973-1975) and 41 Hong Kong Chinese infants (born 1995-1996) were analyzed.
- Height was standardized using SDS based on updated Swedish growth references.
- A historical cohort of 65 Hong Kong Chinese infants (born 1967) was also studied.
Main Results:
- In the Swedish cohort, 92% achieved final height > -2 SDS, with 76% reaching this by 2 months.
- In the 1995-1996 Hong Kong cohort, 79% reached height > -2 SDS by 5 months.
- In the 1967 Hong Kong cohort, 65% reached normal height range by 5 months.
- Early catch-up growth was evident as early as 12 weeks in the 1995-1996 Hong Kong cohort.
Conclusions:
- Early postnatal growth monitoring in infants born short for GA provides valuable insights into their catch-up growth potential.
- Catch-up growth can be identified very early, suggesting timely clinical intervention is possible.
- Growth patterns indicate significant catch-up growth occurs within the first few months of life for infants born SGA.
Abstract:
Postnatal catch-up growth in infants born small for gestational age has been reported to occur mainly during the initial 3-9 months of life. The study presented here characterized early postnatal growth in healthy, full-term infants born short for gestational age (GA) (< -2 standard deviation scores [SDS] in birth length) in two populations. Results from a longitudinal growth study from birth to final height of 139 infants born short for GA between 1973 and 1975 in Göteborg, Sweden, were compared with results from an ongoing detailed prospective 6-month follow-up of 41 Hong Kong Chinese infants born short for GA in 1995 and 1996. For both populations, height was expressed in SDS using the updated Swedish growth reference data at birth and postnatally. In the Swedish study, 92% of the children born short for GA reached a final height greater than -2 SDS; 76% had a height greater than -2 SDS by 2 months of age. In the Hong Kong study, 79% reached a height greater than -2 SDS by 5 months of age (the longest follow-up time to date). A third population of Hong Kong Chinese infants born short for GA in 1967 was studied; 65% had reached the normal height range by 5 months of age. In the later Hong Kong study (1995-1996), catch-up growth could be identified as early as 12 weeks of age, which has important implications for clinical practice. Thus, growth monitoring during the first weeks of postnatal life gives useful information on catch-up growth in infants born short for GA.
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