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Height at 2 and 5 years of age in children born very preterm: the EPIPAGE study
  1. V Pierrat1,2,
  2. L Marchand-Martin2,3,
  3. I Guemas4,
  4. J Matis5,
  5. A Burguet,
  6. J C Picaud5,
  7. J Fresson5,
  8. C Alberge5,
  9. S Marret5,
  10. J C Roze5,
  11. M Kaminski2,3,
  12. B Larroque2,3,
  13. P Y Ancel2,3,
  14. the Epipage Study Group
  1. 1Neonatal Unit, University Teaching Hospital, Hôpital Jeanne de Flandre, Lille Cedex, France
  2. 2INSERM, UMR S 953, IFR 69, Research Unit on Perinatal Health and Women's and Children's Health, Villejuif, France
  3. 3UPMC Univ Paris 06, UMR S 953, Paris, France
  4. 4Pediatric Endocrinology Unit, University Teaching Hospital, Hôpital Jeanne de Flandre, Lille Cedex, France
  5. 5See the end of this paper for these authors' affiliations
  1. Correspondence to Dr Véronique Pierrat, University Teaching Hospital Hôpital Jeanne de Flandre, Service de Médecine Néonatale, Avenue Eugène Avinée, 59037 Lille Cedex, France; vpierrat{at}chru-lille.fr

Abstract

Objectives To evaluate growth for children born very preterm with particular focus on those born small-for-gestational age (SGA) or with ex utero growth restraint (GR), and to identify risk factors for short stature at 5 years of age.

Study design Population-based study of children born at less than 33 completed weeks of gestation (Étude Epidémiologique sur les Petits Ages Gestationnels (EPIPAGE)). Short stature was defined as height <−2SD on WHO growth curves. Ex utero GR was considered to have occurred in children with appropriate size for gestational age at birth and with a height and/or weight below −2SD at 2 years of corrected age. Logistic regression models were used to test associations between risk factors and short stature.

Results The authors measured height at 5 years of age for 1597 of 2193 children (73%), 5.6% (95% CI 4.6 to 6.9) of whom were diagnosed as having a short stature. Height was measured at 2 and 5 years of age in 1417 children. Among these, 24% of those born SGA and 36% of those with ex utero GR (p=0.002) had a short stature at 5 years. Predictors of short stature were SGA or birth length <−2SD, maternal height ≤ 160 cm, gestational age <29 weeks and systemic corticosteroids. Breastfeeding at discharge decreased the risk of short stature.

Conclusions Short stature at 5 years of age is common in children born preterm. The highest incidence was observed in the group with ex utero GR. Systemic steroids have a long-term impact on growth and should be used with caution. Breastfeeding at discharge appeared to be protective.

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Footnotes

  • Epipage Study Group INSERM UMR S149, IFR 69: B Larroque (national coordinator, email beatrice.larroque{at}bjn.aphp.fr), PY Ancel (email pierre-yves.ancel{at}inserm.fr), B Blondel, G Bréart, M Dehan, M Garel, M Kaminski (email monique.kaminski{at}inserm.fr), F Maillard, C du Mazaubrun, P Missy, F Sehili, K Supernant,

  • Alsace M Durant, J Matis (email jacqueline.matis{at}chru-strasbourg.fr) B Langer. University Teaching Hospital de Hautepierre, Avenue Moliere, 67100 Strasbourg, France

  • Franche-Comté A Burguet (email burguet{at}yahoo.com), L Abraham-Lerat, A Menget, P Roth, J-P Schaal, G Thiriez. University Teaching Hospital St Jacques, 2 Place St Jacques, 25030 Besançon, France

  • Haute-Normandie C Lévêque, S Marret (email stephane.marret{at}chu-rouen.fr), L Marpeau. University Teaching Hospital Charles Nicolle, 1 rue Germont, 76031 Rouen, France

  • Languedoc-Roussillon P Boulot, J-C Picaud (email jc.picaud{at}chu-lyon.fr). University Teaching Hospital Arnaud de Villeneuve, 371 av du Doyen Gaston Giraud, 34000 Montpellier, France, A-M Donadio, B Ledésert (ORS Montpellier),

  • Lorraine M André, J-L Boutroy, Fresson J (email j.fresson{at}maternite.chu-nancy.fr), Hascoët JM. University Teaching Hospital, Maternité Régionale, 10 rue du Dr Heydenreich, 54000 Nancy, France

  • Midi-Pyrénées C Arnaud, H Grandjean (INSERM U558, Toulouse), M Rolland, C Alberge (email alberge.c{at}chu-toulouse.fr). University Teaching Hospital Purpan, 1 place du Dr Baylac, 31059 Toulouse, France

  • Nord-Pas-de-Calais C Leignel, A Fily, V Pierrat, D Subtil, P Truffert. University Teaching Hospital Jeanne de Flandre, 2 av Eugène Avinée, 59037 Lille, France

  • Pays de la Loire G Boog, V Rouger-Bureau, J-C Rozé (email jeanchristophe.roze{at}chu-nantes.fr). University teaching Hospital Hôpital Mère-Enfants, Route de St Herblain, 44100 Nantes, France.

  • Paris-Petite-Couronne P-Y Ancel, G Bréart, M Kaminski, C du Mazaubrun (INSERM U149, Paris), M Dehan, V Zupan (Hôpital Antoine Béclère, Clamart), M Vodovar, M Voyer (Institut de Puériculture, Paris).

  • Funding This research was supported by grants from INSERM (National Institute of Health and Medical Research), the Directorate General for Health of the Ministry for Social Affairs, Merck-Sharp and Dohme-Chibret, the Medical Research Foundation and Hospital Program for Clinical Research 2001 n°AOM01117 of the French Department of Health.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the Comission Nationale de l’Informatique et des Libertes, which is the French data-protection agency, Paris, France.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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