ESPE Abstracts

Background: Growth patterns in early childhood have profound implications for long-term health outcomes. This study aim ed to compare the growth trajectories of Small for Gestational Age (SGA) and Appropriate for Gestational Age (AGA) preterm infants over the first 60 months of life.

Methods: A longitudinal analysis of Z-scores for weight-for-age (WAZ), length-for-age (LAZ), and weight-for-length (WLZ) was conducted on preterm infants categorized at birth as either SGA (n = 10) or AGA (n = 50). Data were collected at birth and at 2, 4, 6, 12, 18, 24, 36, and 60 months.

Results: At birth, the SGA group exhibited a mean WAZ of -5.20, LAZ of -5.86, and WLZ of -7.36, indicating significant deviation from the reference population norms. By 60 months, the SGA group showed improvement toward the mean with WAZ at -0.55, LAZ at -1.04, and WLZ at -0.18. The AGA group presented with initial Z-scores of WAZ -5.63, LAZ -6.31, and WLZ -7.73, which by 60 months had approached or surpassed reference norms (WAZ -0.29, LAZ 0.80, WLZ -0.56). Notably, the AGA group's LAZ at 60 months exceeded the mean, suggesting a significant catch-up in height. For SGA preterms, the WAZ, LAZ, and WLZ scores are negative at birth and remain negative throughout the 60 months, indicating that these children are consistently below the reference population in weight, length, and body mass distribution. The numbers do get closer to zero over time, suggesting some degree of catch-up growth, but they do not reach the average (a score of zero would indicate the average). For AGA preterms, the Z-scores also start negative but are less so compared to the SGA preterms. This suggests that AGA preterms are closer to the average size of the reference population at each time point. The scores for AGA preterms also improve over time, with the LAZ score even becoming positive by 60 months, indicating that these children have caught up or surpassed the average height of their age group.

Conclusion: AGA preterm infants demonstrate a more favorable growth pattern, with a tendency to catch up to or exceed population averages, particularly in height. SGA infants exhibit gradual improvement over time. These findings underscore the need for targeted nutritional and medical interventions for SGA infants to support optimal growth and developmental outcomes.