Catch-Up Growth in 166 Small-for- Gestational Age Premature Infants Weighing Less than 1,000 g at Birth

Abstract

Catch-up growth was studied in 166 children born with an extremely low birth weight (<1,000 g) and small-for-gestational age (SGA, <10th percentile birth weight for gestational age). Of these children 159 were followed up for between 4 and 18 years (median 9 years). Group A, SGA <10th percentile of Lubchenco curves only; group B, <10th percentile of Mamelle’s curves but >5th percentile, and group C, <5th percentile of Mammelle’s curves. Catch-up growth was considered to be achieved when height, weight, and head circumference (HC) reached –2 SD of French reference data and remained above this limit afterwards. Catch-up growth in height was achieved in 126/156 children or 81% (group A 88%; group B 84%; group C 74%), before 3 years of age in 100/127 (78%). Seven children below –2 SD received growth hormone (1 child who caught up was excluded from the results). Catch-up growth in weight was achieved in 126/159 children or 79% (group A 86%; group B 82%; group C 73%), before 3 years of age in 87/126 (69%). Catch-up growth in HC was achieved in 126/156 or 81% (group A 78%; group B 92%; group C 77%), before 3 years of age in 102/127 (80%). Overall catch-up growth was achieved for all three parameters in 65% of children, two of three parameters in 19%, and one of three parameters in 8%. Eleven children never caught up on any parameter. While weight is a lesser concern and HC is not liable to intervention, a greater number of short children might benefit from growth hormone therapy.

Underweight and Obesity in Low Birth Weight Children in Early Infancy in Japan

“…Investigators have reported retarded height and weight growth among LBW, especially in VLBW children [10] [11]. Although most LBW children experience catch-up growth by adolescence, the precise time of catch-up is highly diverse and appears to depend on their weight and gestational age at birth [6]- [9]. In fact, several studies have reported that SGA infants were more likely to remain smaller throughout childhood and adulthood than infants born at weights appropriate for gestational age (AGA) [8] [11] [28].…”

“…After initial postnatal growth failure, most preterm infants exhibit catch-up growth in weight, height, and head circumference, generally starting early in the neonatal period and with catch-up occurring by early infancy [6] [7]. However, some investigators have reported delayed catch-up growth to childhood [7] [8] or adolescence [9].…”

Crescimento e desenvolvimento a longo prazo do prematuro extremo

“…40 One aspect peculiar to this study was the presence of 37 sets of twins/triplets. In a subsequent study, 36 pairs of premature infants less than 1,000 g in which one sibling was small for gestational age and another was appropriate for gestational age were studied with the aim of investigating the role of IUGR and the postnatal environment on the growth, development and academic performance of these children.…”

“…11,[36][37][38][39][40] Intrauterine growth restriction is a common pathological condition, especially in developing countries, and has awakened great concern because of its association with future diseases of adulthood, such as : arterial hypertension, diabetes, hyperlipidemia and coronary disease. 41 Although a majority (80%) of babies born with IUGR exhibit catch-up growth during the first 2 years of life, generally during the first 6 months, there is great concern for those that do not catch up, since these children have a worse prognosis for intellectual development 42 and half of them will also become adults of small stature.…”

“…13,48,49 The fact that ELW children progress with smaller stature until adolescence leads to questions about the possibility of growth hormone use, but in few studies has bone age been tested and when hormone has been used results have been inconclusive. 13,40 There is not currently enough evidence to recommend this treatment.…”