Aims: To examine growth, body composition and glucose metabolism during childhood in children born small for gestational age (SGA).
Methods: Single centre cohort study of 150 children (63 boys), identified from newborn records as being born SGA (birth weight SDS <−1.5) and assessed between the age of 4 and 7 years. Data collected included: anthropometric parameters (height, weight, BMI: transformed into age- and sex-adjusted SDS), lean and fat mass assessed by DEXA scans, blood pressure, fasting glucose and C-peptide. Children were compared based on the presence or absence of catch-up growth in weight, defined as a difference in weight SDS between birth and study visit >0.67 SD; or in height, defined as the difference between the childs height SDS and mid-parental height SDS (> or <1 SD).
Results: 150 children with a birth weight of 2485±377gr (SDS: −2.0±0.5) were assessed at a mean age of 6.1±0.8 years. At study visits, height SDS was −0.5±0.9, weight SDS: −0.6±1.0, BMI SDS: −0.5±1.0. Eleven children (7.3%) had a height <−2 SD. 122 (81.3%) children showed catch-up growth in weight; they were taller (height SDS: −0.24±0.76 vs −1.45±0.93, P<0.001), heavier (BMI SDS: −0.31±0.98 vs −1.20±0.63, P<0.001), and showed higher systolic blood pressure SDS (0.08±0.71 vs −0.32±0.63, P=0.009), fasting glucose (4.5±0.5 vs 4.3±0.5 mmol/l, P=0.03) and a trend towards higher C-peptide levels (305.6±116.4 vs 258.5±112.0 pmol/l, P=0.08) compared with those without weight-catch up. They also showed increased total fat mass (adjusted for height) (36.5±16.2 vs 28.3±9.4 g/cm, P=0.01) and lean mass (129.0±14.0 vs 117.2±12.9 g/cm, P<0.001). Classifying children based on catch-up in height, those who did not show any catch-up growth had lower lean mass (adjusted for height): 119±13.3 vs 131±12.8 g/cm, P<0.001, but there were no differences in BMI, fat mass, glucose, C-peptide or blood pressure compared with those with height-catch-up.
Conclusion: Within this cohort of children born SGA and assessed during childhood, those who showed catch-up growth in weight were relatively taller, had higher fat and lean mass, higher blood pressure and fasting glucose, whereas those children who did not show any catch-up growth in height showed mainly reduced lean mass.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology