Premature infants born small by gestational age (SGA) represent a potential cohort for growth retardation. However, up to the present time, questions of the frequency and severity of the growth deficit, the timing of the growth rate, the age of achievement of the population standard depending on the gestational age have been discussed.
Aim: To assess the dynamics of growth of preterm infants born small by gestational age within 5 years of life, taking into account the gestational age.
Materials and methods: A total of 43 preterm infants with SGA and 44 preterm infants appropriate for gestational age (AGA) were included in the control group with a distribution of them depending on the gestational age: 2231 weeks and 3236 weeks. SGA was diagnosed at a mass and/or body length below the 10th percentile for gestational age (Fenton T.R.). Growth rates were estimated taking into account the adjusted age at 6 months, 1, 2, 3, 4, 5 years with SDS counting (Auxology 1.0). Statistical processing of the results was carried out using nonparametric methods.
Results: Preterm infants with AGA with a gestational age of more than 32 weeks had optimal growth rates consistent with population standards throughout the follow-up period. Preterm infants with SGA and gestational age >32 weeks reached the control group and population values by the age of 3 years: a median of 93 cm (89, 95), −0.03 S.D. (−0.08, 0.12). Preterm infants with AGA with a gestational age of less than 32 weeks had growth rates that differed from population values from −0.3 to −1.1 S.D. There was no clear trend to improve the growth rates by 5 years: a growth median of 103 cm (100; 106), −1.1 S.D. (−1.4, −0.9). Premature infants with SGA and gestational age less than 32 weeks had the most pronounced growth retardation: from −2.3 S.D. in 1 year to −1.5 S.D. at 5 years of age. Deficiency of growth more than −2 S.D. in different age periods had from 1/4 to half of children of this group. The strongest correlation of growth with gestational age was noted in the group of prematurity with SGA (r=0.40.8, P<0.05).
Conclusions: Preterm infants with SGA and gestational age of less than 32 weeks have a high risk of growth retardation in the first 5 years of life and require in-depth examination to address the issue of hormone growth therapy.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology