Published online August 1, 2006
PEDIATRICS Vol. 118 No. 2 August 2006, pp. 640-643 (doi:10.1542/peds.2006-0103)
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ARTICLE

Long-term Height Gain of Prematurely Born Children With Neonatal Growth Restraint: Parallellism With the Growth Pattern of Short Children Born Small for Gestational Age

Martijn J.J. Finken, MDa,b, Friedo W. Dekker, PhDb, Francis de Zegher, MD, PhDc, Jan M. Wit, MD, PhDa for the Dutch Project on Preterm and Small-for-Gestational-Age-19 Collaborative Study Group

a Departments of Pediatrics
b Clinical Epidemiology, Leiden University Medical Center, Leiden, Netherlands
c Department of Woman and Child, University of Leuven, Leuven, Belgium

BACKGROUND. It is unknown whether children born very preterm (<32 weeks' gestation) with appropriate size for gestational age, who grow poorly in the first postnatal months (ie, preterm growth restraint), show a similar growth pattern as children born small for gestational age.

OBJECTIVE. Childhood growth and adult height of children with preterm growth restraint were compared to those of very preterm small-for-gestational-age and non–preterm-growth-restraint children.

METHODS. Data were drawn from the Project on Preterm and Small-for-Gestational-Age Infants cohort. Preterm growth restraint was considered to have occurred after appropriate-size-for-gestational-age birth and if length and/or weight was below –2 SD score at 3 months postterm.

RESULTS. Among 380 very preterm children, 274 experienced no preterm growth restraint and showed near-normal growth, whereas 79 (21%) experienced preterm growth restraint and subsequently displayed a growth pattern similar to that of very preterm small-for-gestational-age children (n = 27). Adult height of these children was –1.1 to –1.2 SD score. Very preterm small-for-gestational-age and preterm-growth-restraint children with a height below –2 SD score at 5 years had an adult height of approximately –2.5 SD score.

CONCLUSIONS. Childhood growth and adult height were similar in very preterm small-for-gestational-age and preterm-growth-restraint children. These long-term findings further strengthen the plausibility of extending the small-for-gestational-age indication for growth hormone therapy in such a way that preterm-growth-restraint children are no longer excluded if they have a short stature persisting beyond the age of ~5 years.

Key Words: follow-up studies • prospective study • neonatal morbidity • premature infants • growth patterns

Abbreviations: PGR—preterm growth restraint • AGA—appropriate size for gestational age • SGA— small for gestational age • SDS—SD score • GH—growth hormone

Accepted Mar 23, 2006.




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