The Small-for-Date Infant I. Later Growth Patterns

Abstract

In a prospective study, 96 of a possible 131 full term small-for-date (SFD) infants have been followed for a minimum of 4 years. Serial measurements for weight, height, and head circumference have been compared with the Stuart growth percentiles. By 4 years of age the mean weight and height were between the 10th and 25th percentiles with 35% below the 3rd and only 8% above the 50th percentiles. Increase in head circumference paralleled linear growth. Bone age showed a high positive correlation with height age. Siblings of normal birth weight tended to be larger than the study children with 3% below the 3rd and 45% above the 50th percentiles. Heights of parents were normal, mothers were slightly underweight. There was no difference in the 6-year height or weight between the most severely intra-uterine retarded babies and their less affected counterparts. The growth pattern of the SFD children was similar to the normal child with the greatest velocity of growth occurring in the first 6 months. Those children whose 4-year height exceeded the 3rd percentile showed an accelerated velocity of growth in the first 6 months.

Body composition in preterm infants fed standard term or enriched formula after hospital discharge

“…In addition the percentage of infants with a length below the reference range for corrected gestational age at discharge is several times greater than at birth [1,2]. Various studies have indicated that the window for catch-up growth in growth-retarded babies is limited and that if such growth has not taken place in in-fancy, the chances that it will occur later diminish [3][4][5]. In humans, the importance of nutrition in early life is now well known, and the term "programming" has been proposed to emphasise that early nutrition should be considered not simply in terms of providing immediate nutritional needs but also because of certain biological effects that may have lasting or lifelong significance [5].…”

Growth As a Measure of Nutritional Status

“…Perhaps longer follow-up periods will document this in other study populations as well. Both term and preterm infants who are small for gestational age have less capacity for catch-up growth (101,113,114). Dysmaturity may not alter the capacity for catch-up growth (115).…”

“…On the other hand, persistently small head circumference may be associated with neurologic dysfunction (100,104). Head circumference growth generally parallels linear growth (112,113,116) and disproportionately rapid "catch-up" or slow head growth should be a cause for concern.…”

“…Low birth weight infants (preterm and small for gestational age) manifest postnatal growth that frequently does not conform to standard growth percentiles (98)(99)(100)(101)(102)(103)(104)(105)(106)(107)(108)(109)(110)(111)(112)(113)(114). As pediatric inpatient populations often contain substantial ' number s of these children, their growth is of obvious importance.…”

Follow‐up of Children Born to Hypertensive Mothers

“…Maternal hypertension is the most common cause of intrauterine growth retardation. There have been many studies of long‐term follow‐up of small for gestational age babies 1–6 . These are often a heterogenous group, even if babies with major congenital malformations, chromosomal abnormalities or congenital viral infections are excluded.…”