Objective To investigate growth trajectories from age 2.5 to 19 years in individuals born before 26 weeks of gestation (extremely preterm; EP) compared with term-born controls.
Methods Multilevel modelling of growth data from the EPICure study, a prospective 1995 birth cohort of 315 EP participants born in the UK and Ireland and 160 term-born controls recruited at school age. Height, weight, head circumference and body mass index (BMI) z-scores were derived from UK standards at ages 2.5, 6, 11 and 19 years.
Results 129 (42%) EP children were assessed at 19 years. EP individuals were on average 4.0 cm shorter and 6.8 kg lighter with a 1.5 cm smaller head circumference relative to controls at 19 years. Relative to controls, EP participants grew faster in weight by 0.06 SD per year (95% CI 0.05 to 0.07), in head circumference by 0.04 SD (95% CI 0.03 to 0.05), but with no catch-up in height. For the EP group, because of weight catch-up between 6 and 19 years, BMI was significantly elevated at 19 years to +0.32 SD; 23.4% had BMI >25 kg/m2 and 6.3% >30 kg/m2 but these proportions were similar to those in control subjects. EP and control participants showed similar pubertal development in early adolescence, which was not associated with height at 19 years in either study group. Growth through childhood was related to birth characteristics and to neonatal feeding practices.
Conclusions EP participants remained shorter and lighter and had smaller head circumferences than reference data or controls in adulthood but had elevated BMI.
- extremely preterm
- cohort studies
- growth trajectories
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Contributors YN contributed to the analysis and interpretation of data, drafted the first version of the manuscript and revised it for important intellectual content. JB assisted in the design of the 19-year follow-up study, collected the data, and reviewed and revised the manuscript for intellectual content. RG, JRH and JKM critically reviewed and revised the manuscript for intellectual content. NM conceptualised and designed the study, obtained funding, supervised data collection, and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.
Funding This study was funded by the Medical Research Council UK (MRC Ref MR/J01107X/1). NM receives a proportion of funding from the Department of Health’s NIHR Biomedical Research Centres funding scheme at UCLH/UCL.
Disclaimer NM declares consultancy fees from Novartis and Shire; other authors have no financial relationships to disclose.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The study at 19 years was approved by the South Central Hampshire A Research Ethics Committee (Ref: 13/SC/0514).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available subject to the EPICure Data Sharing Policy (www.epicure.ac.uk).