When they grow up: The growth of extremely low birth weight (≤1000 gm) infants at adolescence

doi:10.1016/S0022-3476(98)70404-4

The Journal of Pediatrics

Volume 132, Issue 6, June 1998, Pages 1033-1035

Presented at the Western Society for Pediatric Research Meeting, Carmel, California, February 9-12, 1994, and at the Society for Pediatric Research Meeting, Seattle, Washington, May 2-5, 1994.

https://doi.org/10.1016/S0022-3476(98)70404-4 Get rights and content

Abstract

The growth of 32 extremely low birth weight infants (1000 gm or less) was determined at adolescence. Their height, weight, and head circumference were measured twice in the first year of life and then at ages 2, 3, 5, 8, 10 years, and during adolescence (12 to 18 years). The mean height, weight, and head circumference of the adolescents were at the 50th percentile. Female heights were ≥ their mothers; male heights were in the same or greater percentile than those of their fathers. Extremely low birth weight infants experience “catch-up” growth up to and into adolescence and attain predicted biparental genetic height. (J Pediatr 1998;132:1033-5.)

Section snippets

Methods

Adolescents who weighed 1000 gm or less at birth and were in the Newborn Intensive Care Unit at Children's Hospital of San Francisco during a 10-year period between January 1, 1972, and December 31, 1981, were eligible for this study. The subjects had been measured in the follow-up clinic at 3 to 8 months and 1, 2, 3, 5, 8, and 10 years of age as part of our longitudinal study.

Written informed consent was obtained, and height, weight, and head circumference of the adolescents were measured at

Subjects

Of the original cohort of 103 infants who had been measured during childhood, measurements as adolescents were obtained for 32 (24%). Mean birth weight for the whole cohort was 846 ± 113 SD gm, and gestational age was 27.2 ± 1.7 weeks.

Mean birth weight for the adolescents was 818 ± 110 gm, and gestational age was 26.6 ± 1.4 weeks. Twenty (63%) of 32 adolescents evaluated were female. A total of 22 white, 8 black, and 2 Asian adolescents were studied. These characteristics were almost identical

Discussion

Delayed catch-up in growth of very low birth weight and extremely low birth weight infants is not evident in early studies with short durations of follow up.3, 4, 5, 6 Kitchen et al.⁷ found that even at 8 years of age up to 16% of very low birth weight Australian children were below the 10th percentile for Ht, Wt, and HC. Saigal et al.⁸ reported from a Canadian regional population that 28% of extremely low birth weight adolescents 12 to 16 years of age were less than the 10th percentile in Ht.

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Pediatric health supervision, physical growth
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Is intensive care justified for infants weighing less than 801 gm at birth?
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Growth to age 3 years among very low-birth-weight sequelae-free survivors of modern neonatal intensive care
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La fuerza es una cualidad con clara influencia sobre la calidad de vida. Está condicionada por la estructura del aparato locomotor y es directamente dependiente de la estructura muscular. Se ha descrito que ambas cualidades están condicionadas por la prematuridad. Son objetivos del estudio conocer si la prematuridad está relacionada con la fuerza o la composición corporal durante la infancia y valorar la relación entre prematuridad, fuerza y masa muscular.
Estudio de casos y controles realizado en niños de entre 7 y 11 años con desarrollo normal y controles a término de la misma edad. Se incluyó a 89 sujetos: 30 prematuros con peso al nacimiento ≤ 1.500 g, 29 prematuros con peso al nacimiento > 1.500 g y 30 controles. Se analizaron antropometría, composición corporal mediante absorciometría de rayos X de energía dual y fuerza isométrica mediante banco inclinado y galga.
El peso y el IMC fueron menores en los niños que pesaron ≤ 1.500 g. No se observaron diferencias en composición corporal ni fuerza. Se estableció una razón entre fuerza y masa muscular, resultando esta de un peso desplazado 4 veces superior al peso corporal, no encontrándose diferencias entre grupos ni relación con el peso al nacimiento.
Entre los 7 y los 11 años de edad, los niños que fueron grandes prematuros tienen un peso y un IMC menores al resto de los niños. No se encontraron diferencias entre prematuros y controles en cuanto a composición corporal y fuerza muscular.
Strength is a physical quality with a clear influence on quality of life. It is determined by the structure of the musculoskeletal system, and depends on the muscular structure. It has been described that prematurity conditions both qualities. The aims of this study are to determine whether prematurity is associated with strength or body composition and evaluate the relationship between prematurity, strength and muscle mass.
Case-control study. Participants were premature 7-to-11 year-old children and full-term birth controls. Strength was measured by a strength gauge and body composition from DEXA (duel-energy X-ray absorptiometry) scans. A total of 89 subjects were included and divided into three groups: 30 prematures with birth-weight ≤ 1500 g, 29 prematures with birth-weight 1500-2000 g, and 30 controls.
Weight and BMI z-score was lower in the premature group. No differences were found in muscular mass or strength between groups. A ratio was established between strength and weight or muscular mass. It was observed that it was possible for them to move four times their weight, without finding any differences between groups or a relationship with birth-weight.
Between 7 and 11 years of age, children who were premature have lower weight and BMI than the rest of the children. However, there were no differences in body composition or strength between preterm children and controls.
The growth of very-low-birth-weight infants at 5 years old in Taiwan
2014, Pediatrics and Neonatology
Citation Excerpt :
Among the long-term complications linked to prematurity, the growth pattern of VLBW infants has been of great concern to parents and medical professionals alike because growth after discharge is a good measure of physical, neurologic, and environmental well-being.1 Although “catch-up” growth has been reported, large-sample studies have revealed the persistence of poor growth among VLBW from birth through adolescence.3,4 In addition, it has been estimated that approximately half of VLBW infants develop cognitive and behavioral deficits.5
The goal of this study was to compare the growth and effect of growth on cognitive performance at 5 years of age of a group of very-low-birth-weight (VLBW) infants and a group of healthy full-term infants.
Beginning in 1995, under the sponsorship of the Premature Baby Foundation, the Society of Neonatology, Taiwan, conducted a multicenter follow-up study of VLBW infants in Taiwan. The study enrolled 322 VLBW infants and 103 controls for assessment of growth data and cognitive performance at several time points from birth through to 5 years of age. Growth data were assessed with measurements of weight, height, and head circumference taken at the ages of 6 months, 12 months, 24 months, and 60 months. Cognitive performance was assessed at the age of 5 years. The VLBW infants were regarded as “failed” if a measurement was 2 standard deviations below the mean measurement of the control group. Neonatal and perinatal data had been collected prospectively as part of a longitudinal study. Cognitive performance was assessed using the Chinese version of the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-R).
From 6 months to 5 years, VLBW infants had lower weight, height, and head circumference than the controls. Two hundred twenty-four VLBW infants (69.6%) returned for assessment at 5 years old. Of the 224 VLBW infants, complete sets of measurements of weight, height, and head circumference were obtained for 126 cases (56.3%), 127 cases (56.7%), and 106 cases (47.3%), respectively. Of these, 13 patients (10.3%) failed in weight, 11 patients (8.7%) failed in height, and 17 patients (16.0%) failed in head circumference at the age of 5 years. The mean WPPSI-R scores at the age of 5 years for VLBW children were: 94.1 ± 16.4 (performance IQ), 87.2 ± 12.8 (verbal IQ), and 89.5 ± 14.6 (full IQ). All of these values were also lower than those of the control group, with the differences being statistically significant (p < 0.05). The WPPSI-R scores of VLBW children who failed in head circumference were notably lower than those of VLBW children whose head circumference had caught up with that of their peers.
The growth of VLBW infants was lower than that of healthy full-term infants through 5 years of age. The cognitive performance for VLBW children was also decreased compared to that of the control group, and there was an association between slower growth and decreased cognitive ability.
Patterns of catch-up growth
2013, Journal of Pediatrics
Catch-up growth of supine length/height of very low birth weight, small for gestational age preterm infants to adulthood
2005, Journal of Pediatrics
Citation Excerpt :
Contrary to HC growth, height catch-up occurred across the entire growth period as long as velocity was sufficiently high and the environmental conditions were good. Similar results have been reported by Hirata and Bosque,28 Ford et al,7 Saigal et al,8 Hack et al,1 and Doyle et al.29 Delayed catch-up in growth of VLBW infants was not evident in early studies with short follow-up durations.2,4,6 Overall our results were poorer for boys, as in the study of Hack et al,1 where the VLBW males remained significantly shorter than their AGA counterparts at age 20 (< −2 SD).
To analyze linear growth of very low birth weight (VLBW), small for gestational age (SGA; < 10th percentile) preterm infants from birth as to catch-up or no catch-up growth.
VLBW SGA preterm infants (n = 46) with primarily symmetric intrauterine growth restriction from the Bonn Longitudinal Study were compared with 62 appropriate for gestational age (AGA) VLBW preterm and 73 term infants and with their parents.
Forty-six percent of VLBW SGA (21 of 46) had complete height catch-up by adult age, and most became taller than target height (TH) (15 of 21; 71%). The others did not catch up; most of them remained shorter than TH (18 of 25; 72%) after initial catch-up followed by catch-down growth. Mean adult height z-score was lower than that for birth length. Mean body mass index was similar in the catch-up and no catch-up groups (21.8 and 21.3, respectively) and lower than in the controls (23.2). Approximately 1/2 of the head circumference (HC) catch-up children achieved height catch-up as well.
Height catch-up extended beyond age 6 years, independent of HC growth. We could not predict height catch-down or successful catch-up.
Extreme prematurity: Optimism or pessimism?
2004, Archives de Pediatrie
Associations between size at birth and size at 6 years among preterm infants: a retrospective cohort study
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^☆: From the Department of Pediatrics, California Pacific Medical Center, San Francisco, California.

^☆☆: Supported by a grant from the California Pacific Medical Center Research Institute and from private funding.

^★: Reprint requests: Toshiko Hirata, MD, Newborn Services, California Pacific Medical Center, 3850 California St., San Francisco, CA 94118.

^★★: 9/22/87968

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When they grow up: The growth of extremely low birth weight (≤1000 gm) infants at adolescence☆,☆☆,★,★★

Abstract

Section snippets

Methods

Subjects

Discussion

J Pediatr

Pediatric health supervision, physical growth

Is intensive care justified for infants weighing less than 801 gm at birth?

J Pediatr

Growth to age 3 years among very low-birth-weight sequelae-free survivors of modern neonatal intensive care

J Pediatr