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Fitzhardinge, P.M. and Inwood, S. (Mount Sinai Hospital, Toronto, Ontario, Canada). Long-term growth in small-for-date children. Acta Paediatr Scand [Suppll 349: 27, 1989.The growth patterns of 158 infants with significant intrauterine growth retardation (IUGR) were studied for the first 2 years of life. Eighty-four infants were born after 36 completed weeks. All these full-term infants survived; complete follow-up data were obtained for 78. Acceleration of growth in weight began soon after birth and continued for an average of 6 months. Acceleration of linear growth began somewhat later, but was limited to the first 9 months. Twenty-three infants (29%) were still below the 5th centile for both weight and height by 2 years of age. There was a negative correlation between the neonatal ponderal index and length at 18 months for females only. Seventy-four infants were born prematurely, before 37 weeks' gestation. Mortality in this group was 18% and complete follow-up data were obtained for 49 of the 61 survivors. Birth weight was regained on average at 11 days; accelerated weight velocity began 4-6 weeks before the expected date of delivery (term date). The potential for catch-up growth lasted up to 9 months after the term date. By 18 months, however, 44% of these pre-term infants were still below the 5th centile for weight. Size at 18 months post-term was correlated with weight at the term date and length at 3 months postterm, but not with the degree of IUGR or with the ponderal index.

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The findings at autopsy were correlated with the computed tomographic (CT) diagnosis in 90 neonates that had suffered perinatal hypoxia and had CT within 10 days before autopsy. CT was accurate in the diagnosis of supratentorial hemorrhage whether it was subependymal, intraventricular, or intracerebral. Infratentorial hemorrhage was difficult to detect or localize with accuracy. Correlation between areas of hypodense brain tissue seen on CT and areas of ischemic brain damage other than hemorrhage at autopsy was poor. Diagnosis of generalized cerebral edema by CT, however, was very good.