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Growth in 10- to 12-year-old children born at 23 to 25 weeks' gestation in the 1990s: a Swedish national prospective follow-up study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Pediatrics. (Perinatal, neonatal och barnkardiologisk forskning/Sedin)
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2006 (English)In: Pediatrics, ISSN 0031-4005, E-ISSN 1098-4275, Vol. 118, no 5, E1452-E1465 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND. Knowledge of long-term growth of extremely preterm infants in relation to gestational age is incomplete, and there are concerns regarding their poor growth in early childhood. As part of a longitudinal study of a national cohort of infants born at < 26 weeks' gestation (extremely immature), growth development from birth to the age of 11 years was examined, and correlates of growth attainment were analyzed.

METHODS. Two hundred forty-seven extremely immature children were born alive from April 1990 through March 1992 in the whole of Sweden, and 89 ( 36%) survived. Growth and neurosensory outcomes of all extremely immature survivors were evaluated at 36 months of age. Eighty-six (97%) extremely immature children were identified and assessed at 11 years of age. In this growth study, 83 extremely immature infants (mean [SD]: birth weight, 772 g [110g]; gestational age, 24.6 weeks [0.6 weeks]) without severe motor disability were followed up prospectively from birth to 11 years old and compared with a matched group of 83 children born at term. z scores for weight, height, head circumference, and BMI were computed for all children. We also examined gender-specific longitudinal growth measures. Predictors of 11-year growth were studied by multivariate analyses.

RESULTS. Extremely immature children were significantly smaller in all 3 growth parameters than the controls at 11 years. Extremely immature children showed a sharp decline in weight and height z scores up to 3 months' corrected age, followed by catch-up growth in both weight and height up to 11 years. In contrast to weight and height, extremely immature children did not exhibit catch-up growth in head circumference after the first 6 months of life. The mean BMI z scores increased significantly from 1 to 11 years in both groups. The mean BMI change between 1 and 11 years of age was significantly larger in extremely immature than in control participants. Extremely immature girls showed a faster weight increase than extremely immature boys, whereas catch-up growth in height and head circumference was similar in these groups. Multiple-regression analyses revealed that preterm birth and parental height were significant predictors of 11-year height, and group status (prematurity) correlated strongly with head circumference.

CONCLUSIONS. Children born at the limit of viability attain poor growth in early childhood, followed by catch-up growth to age 11 years, but remain smaller than their term-born peers. Strategies that improve early growth might improve the outcome.

Place, publisher, year, edition, pages
2006. Vol. 118, no 5, E1452-E1465 p.
Keyword [en]
growth, extremely immature
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-20049DOI: 10.1542/peds.2006-1069ISI: 000241731700098PubMedID: 17079546OAI: oai:DiVA.org:uu-20049DiVA: diva2:47821
Available from: 2006-12-05 Created: 2006-12-05 Last updated: 2017-12-08Bibliographically approved

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Sedin, GunnarSerenius, Fredrik

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