ESPE Abstracts

Prematurity combined with intrauterine growth retardation (small to gestational age, SGA) is a potential risk factor for adverse growth prognosis. There is insufficient evidence on this issue.

Aim: to study the growth rates in preterm infants born small to gestational age, different gestational age in the first 5 years of life.

Material and Methods: The prospective study included preterm infants with SGA (group 1, n=100) and preterm infants corresponding to gestational age (group 2, n=69) with a division by gestational age (32-36 weeks and 22-31 weeks). Monitoring of body length/height was carried out at birth, at 6 months, then annually. At the age of 5 years, 48 children of group 1 and 33 children of group 2 completed the study. The data are presented in the form of a median and interquartile interval with an assessment of the significance of the Mann-Whitney differences. The calculation of SD growth was carried out using the program Anthro (WHO).

Results: Body length at birth in preterm infants with gestational age 32-36 weeks corresponded to 44.0 [43.0; 45.0] cm in group 1 and 46.0 [42.0; 48.0] cm in group 2 (P<0.05), significantly differing in SD relative to gestational age: -1.0 [-1.5; -0.4] SD and +0.1 [-0.7; +0.6] SD. Subsequently, children of group 1 achieved growth rates of children of group 2 by 4 years: 100.0 [94.5;102.8] cm and 100.0 [95.7; 105.5] cm, respectively. However, only in group 1 part of children had growth rates less than -2.0 SD (24.2% - in 4 years, 24.2% - in 5 years).

Body length at birth in preterm infants with gestational age of 22-31 weeks corresponded to 34.0 [31.0; 36.0] cm in group 1 and 36.0 [33.0; 40.5] cm in group 2 (P<0.05), significantly differing in SD relative to gestational age: -1.0 [-1.7; -0.4] SD and +0.5 [-0.1; +1.9] SD. During the entire follow-up period, group 1 children had significantly (P<0.05) lower growth rates compared to group 2. At the age of 4 years, their growth corresponded to 94.3 [93.0; 99.0] cm, -2.0 [-2.3; -0.9] SD; in 5 years – 103.0 [99.3; 111.0] cm, -1.4 [-2.1; -0.3] SD. Growth of less than -2.0 SD was registered only in group 1 (53.3% - in 4 years, 33.3% - in 5 years).

Summary: Premature infants with SGA and gestational age of 22-31 weeks have an unfavorable growth prognosis in the first 5 years of life, which determines the direction of further research.