1
|
Nguyen PT, Nguyen PH, Tran LM, Khuong LQ, Nguyen SV, Young MF, Ramakrishnan U. Growth patterns of preterm and small for gestational age children during the first 10 years of life. Front Nutr 2024; 11:1348225. [PMID: 38468696 PMCID: PMC10925699 DOI: 10.3389/fnut.2024.1348225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 02/16/2024] [Indexed: 03/13/2024] Open
Abstract
Background Preterm and small for gestational age (SGA) remain significant public health concerns worldwide. Yet limited evidence exists on their growth patterns during childhood from low-or middle-income countries. Objectives We investigated the postnatal growth patterns of preterm and SGA compared to term appropriate for gestational age (AGA) children from birth to 10-11y, and examined the impact of birth status on child nutritional status during the school age years. Methods Children born to women who participated in a double-blinded randomized controlled trial of preconception micronutrient supplementation in Vietnam were classified into three groups: preterm AGA (n = 130), full-term SGA (n = 165) and full-term AGA (n = 1,072). Anthropometric data (weight and height) were collected prospectively at birth, 3, 6, 12, 18, 24 months and at 6-7 and 10-11y. We used ANOVA and multiple regression models to examine the differences in growth patterns from birth to 10-11y as well as child undernutrition and overnutrition by birth status. Results Children who were born preterm exhibited rapid postnatal growth, but still had lower HAZ at 1y and 2y and showed catch up to the AGA group at 6y. Compared to those born AGA, SGA infants had higher risk of thinness (BMIZ < -2) at 2y and 6y (adjusted Odds Ratio, AOR [95% CI] 2.5 [1.0, 6.1] and 2.6 [1.4, 4.6], respectively); this risk reduced at 10-11y (1.6 [0.9, 2.8]). The risk of stunting (HAZ < -2) was also 2.4 [1.5, 3.8] and 2.3 times [1.2, 4.1] higher in SGA than AGA group at ages 2y and 6-7y, respectively, with no differences at 10y. Although preterm children had higher rates of thinness and stunting at 2y compared to AGA children, these differences were not statistically significant. No associations were found between preterm or SGA and overweight /obesity at age 10-11y. Conclusion Children who were born term-SGA continued to demonstrate deficits in weight and height during childhood whereas those born preterm showed catch-up growth by age 6-7y. Additional efforts to reduce the burden of these conditions are needed, particularly during school-age and early adolescents when children are exposed to challenging environments and have higher demands for nutrition.
Collapse
Affiliation(s)
- Phuong Thi Nguyen
- Department of Pediatric, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - Phuong Hong Nguyen
- Department of Pediatric, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
- Department of Nutrition, Diets, and Health, International Food Policy Research Institute, Washington, DC, United States
| | - Lan Mai Tran
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
| | - Long Quynh Khuong
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, United States
| | - Son Van Nguyen
- Department of Pediatric, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - Melissa F. Young
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
| | - Usha Ramakrishnan
- Hubert Department of Global Health, Emory University, Atlanta, GA, United States
| |
Collapse
|
2
|
李 佳, 谢 群, 文 羽, 宋 燕, 梁 会, 胡 艳. [Longitudinal study on catch-up growth in preterm infants with small for gestational age at corrected ages 0-24 months]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2024; 26:72-80. [PMID: 38269463 PMCID: PMC10817744 DOI: 10.7499/j.issn.1008-8830.2307059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 11/21/2023] [Indexed: 01/26/2024]
Abstract
OBJECTIVES To understand the growth and development status and differences between small for gestational age (SGA) and appropriate for gestational age (AGA) preterm infants during corrected ages 0-24 months, and to provide a basis for early health interventions for preterm infants. METHODS A retrospective study was conducted, selecting 824 preterm infants who received regular health care at the Guangzhou Women and Children's Medical Center from July 2019 to July 2022, including 144 SGA and 680 AGA infants. The growth data of SGA and AGA groups at birth and corrected ages 0-24 months were analyzed and compared. RESULTS The SGA group had significantly lower weight and length than the AGA group at corrected ages 0-18 months (P<0.05), while there were no significant differences between the two groups at corrected age 24 months (P>0.05). At corrected age 24 months, 85% (34/40) of SGA and 79% (74/94) of AGA preterm infants achieved catch-up growth. Stratified analysis by gestational age showed that there were significant differences in weight and length at corrected ages 0-9 months between the SGA subgroup with gestational age <34 weeks and the AGA subgroups with gestational age <34 weeks and 34 weeks (P<0.05). In addition, the weight and length of the SGA subgroup with gestational age 34 weeks showed significant differences compared to the AGA subgroups with gestational age <34 weeks and 34 weeks at corrected ages 0-18 months and corrected ages 0-12 months, respectively (P<0.05). Catch-up growth for SGA infants with gestational age <34 weeks and 34 weeks mainly occurred at corrected ages 0-12 months and corrected ages 0-18 months, respectively. CONCLUSIONS SGA infants exhibit delayed early-life physical growth compared to AGA infants, but can achieve a higher proportion of catch-up growth by corrected age 24 months than AGA infants. Catch-up growth can be achieved earlier in SGA infants with a gestational age of <34 weeks compared to those with 34 weeks.
Collapse
|
3
|
Stativa E, Rus AV, Lee WC, Salinas KAD, Cossey HM, Lobo A, Nanu M. Predictors of height in Romanian infants 6-23 months old: findings from a national representative sample. J Public Health (Oxf) 2023; 45:e714-e721. [PMID: 37740988 DOI: 10.1093/pubmed/fdad180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 08/09/2023] [Indexed: 09/25/2023] Open
Abstract
BACKGROUND The research explored the association between infants' height and various demographic factors in Romania, a country where such critical information has been lacking. METHODS This study was conducted on a nationally representative sample and used a family physicians database to determine a sample of 1532 children (713 girls and 819 boys) 6-23 months of age (M = 14.26; SD = 5.15). Infants' height-for-age z-scores (HAZ) were calculated using the World Health Organization's computing algorithm. A multiple regression analysis was conducted to investigate whether certain risk factors, such as infant mother's age, location, marital status, socioeconomic status (SES), as well as infant's term status at birth, age, anemia, minimum dietary diversity (MDD) and birth order, could significantly predict the HAZ. RESULTS The study identified several significant predictors of height. Specifically, lower HAZ was associated with rural living, preterm birth, age 18-23 months, unmarried mothers, anemia, lack of MDD and being third or later born in the family. In contrast, higher HAZ was associated with medium or high maternal SES and older maternal age. CONCLUSIONS The study underscores the importance of addressing these significant risk factors through distinct interventions to improve height outcomes in at-risk Romanian populations.
Collapse
Affiliation(s)
- Ecaterina Stativa
- The National Institute for Mother and Child Health 'Alessandrescu-Rusescu', Bucharest, Romania
| | - Adrian V Rus
- Southwestern Christian University, Oklahoma, USA
| | - Wesley C Lee
- Southwestern Christian University, Oklahoma, USA
| | | | | | | | - Michaela Nanu
- The National Institute for Mother and Child Health 'Alessandrescu-Rusescu', Bucharest, Romania
| |
Collapse
|
4
|
Gao W, Zhang T, Wang Q, Tang X, Zhang Y. The trajectories of physical growth in 4 months postnatal corrected age among preterm infants discharged from neonatal intensive care units and associated factors: A prospective study. Int J Nurs Sci 2023; 10:206-214. [PMID: 37128488 PMCID: PMC10148260 DOI: 10.1016/j.ijnss.2023.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/15/2023] [Accepted: 03/22/2023] [Indexed: 05/03/2023] Open
Abstract
Objectives Growth retardation is a risk for premature infants. In addition to demographic and perinatal factors, preterm infants' physical growth may be affected by neonatal intensive care unit (NICU) stress, maternal postpartum depression, and mother-infant interaction. This study aimed to investigate the trajectories of physical growth in 4 months corrected age among preterm infants discharged from the NICU and the impactors on these trajectories. Methods A prospective study was conducted among 318 preterm infants from September 2019 to April 2021 in Shanghai, China. Latent growth modeling was applied to identify the weight, length, and head circumference growth trajectories in 4 months corrected age and explore the effects of demographic and medical characteristics, infant stress during NICU stay, maternal postpartum depression, and mother-infant interaction on each trajectory. Results Unconditional latent growth models showed curve trajectories with increasingly slower growth in weight, length, and head circumference until 4 months of corrected age. Conditional latent growth models showed that a longer length of stay in the NICU and more skin punctures were negatively associated with weight at 40 weeks corrected gestational age (β = -0.43 and -0.19, respectively, P < 0.05). The maternal postpartum depression between 40 weeks corrected gestational age and 1 month corrected postnatal age was associated with a lower growth rate of length (β = -0.17, P = 0.040), while between 2 and 3 months corrected postnatal age, there were lower growth rates of weight and head circumference (β = -0.15 and -0.19, respectively, P < 0.05). The mother-infant interaction scores between 40 weeks corrected gestational age and 1 month corrected postnatal age negatively predicted the growth rate of weight (β = -0.19, P = 0.020). Conclusion The physical growth trajectories of preterm infants discharged from the NICU were influenced by infant stress during the NICU stay, maternal postpartum depression and mother-infant interaction.
Collapse
Affiliation(s)
- Wenying Gao
- Shanghai Jiao Tong University, School of Nursing, Shanghai, China
| | - Taomei Zhang
- Shanghai Jiao Tong University, School of Nursing, Shanghai, China
| | - Qihui Wang
- Shanghai Jiao Tong University, School of Nursing, Shanghai, China
| | - Xiaoli Tang
- Shanghai Jiao Tong University, School of Medicine, Shanghai Children’s Medical Center, Department of Neonatology, Shanghai, China
- Shanghai Jiao Tong University, School of Medicine, Shanghai Children’s Medical Center, Department of Nursing, Shanghai, China
| | - Ying Zhang
- Shanghai Jiao Tong University, School of Nursing, Shanghai, China
- Corresponding author.
| |
Collapse
|
5
|
Zhonggui X, Ping Z, Jian K, Feimin S, Zeyuan X. The growth rates and influencing factors of preterm and full-term infants: A birth cohort study. Medicine (Baltimore) 2022; 101:e30262. [PMID: 36042642 PMCID: PMC9410590 DOI: 10.1097/md.0000000000030262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study aimed to explore the growth rates and influencing factors of the length and weight of preterm and full-term infants in the urban areas of Hubei province to provide a reference for child health and related clinical fields. A birth cohort study was used to analyze the growth rates and influencing factors of the length and weight of preterm and full-term infants using a multivariate regression analysis. The growth rates of the length and weight of preterm infants were significantly lower than those of full-term infants from birth to 3 months of age (P < .05), and gradually caught up to the level of full-term infants after 3 months of age (P > .05). Meanwhile, there were some influencing factors that had significant differences by their contribution to the growth rates of the length and weight of preterm and full-term infants. This study proposed that perinatal factors were attached more importance to the growth rates of preterm infants in the urban areas of Hubei province.
Collapse
Affiliation(s)
- Xiong Zhonggui
- Department of Child health, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
- *Correspondence: Xiong Zhonggui, Department of Child Health, Maternal and Child Health Hospital of Hubei Province, 745 Wuluo Road, Hongshan District, Wuhan City 430070, China (e-mail: )
| | - Zhang Ping
- Department of Child health, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Ke Jian
- Department of Child health, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Sun Feimin
- Medical College, Wuhan University of Science and Technology, Wuhan, China
| | - Xia Zeyuan
- Medical College, Wuhan University of Science and Technology, Wuhan, China
| |
Collapse
|
6
|
Sinha B, Choudhary TS, Nitika N, Kumar M, Mazumder S, Taneja S, Bhandari N. Linear Growth Trajectories, Catch-up Growth, and Its Predictors Among North Indian Small-for-Gestational Age Low Birthweight Infants: A Secondary Data Analysis. Front Nutr 2022; 9:827589. [PMID: 35685868 PMCID: PMC9173003 DOI: 10.3389/fnut.2022.827589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/31/2022] [Indexed: 11/17/2022] Open
Abstract
Background Low birthweight small-for-gestational-age (SGA-LBW) (birthweight below the 10th percentile for gestational age; SGA-LBW) infants are at an increased risk of poor postnatal growth outcomes. Linear growth trajectories of SGA-LBW infants are less studied in South Asian settings including India. Objectives To describe the linear growth trajectories of the SGA-LBW infants compared with appropriate-for-gestational-age LBW (AGA-LBW) infants during the first 6 months of life. In addition, we estimated catch-up growth (ΔLAZ > 0.67) in SGA-LBW infants and their performance against the WHO linear growth velocity cut-offs. Additionally, we studied factors associated with poor catch-up growth in SGA-LBW infants. Methods The data utilized came from an individually randomized controlled trial that included low birthweight (LBW) infants weighing 1,500–2,250 g at birth. A total of 8,360 LBW infants were included. For comparison between SGA-LBW and AGA-LBW infants, we presented unadjusted and adjusted estimates for mean differences (MDs) or risk ratios (RRs) for the outcomes of length, linear growth velocity, length for age z-score (LAZ) score, and stunting. We estimated the proportion of catch-up growth. Generalized linear models of the Poisson family with log links were used to identify factors associated with poor catch-up growth in SGA-LBW infants. Results Low birthweight small-for-gestational-age infants had a higher risk of stunting, lower attained length, and a lower LAZ score throughout the first 6 months of life compared with AGA-LBW infants, with differences being maximum at 28 days and minimum at 6 months of age. The linear growth velocity in SGA-LBW infants compared with AGA-LBW infants was significantly lower during the birth–28 day period [MD −0.19, 95% confidence interval (CI): −0.28 to −0.10] and higher during the 3- to 6-month period (MD 0.17, 95% CI: 0.06–0.28). Among the SGA-LBW infants, 55% showed catch-up growth for length at 6 months of age. Lower wealth quintiles, high birth order, home birth, male child, term delivery, non-exclusive breastfeeding, and pneumonia were associated with the higher risk of poor catch-up in linear growth among SGA-LBW infants. Conclusion Small for gestational age (SGA) status at birth, independent of gestational age, is a determinant of poor postnatal linear growth. Promotion of institutional deliveries, exclusive breastfeeding, and prevention and early treatment of pneumonia may be helpful to improve linear growth in SGA-LBW infants during early infancy. Clinical Trial Registration [https://clinicaltrials.gov/], identifier [NCT02653534].
Collapse
Affiliation(s)
- Bireshwar Sinha
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India.,DBT/Wellcome India Alliance, Hyderabad, India
| | - Tarun Shankar Choudhary
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Knowledge Integration and Transformation Platform at Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Nitika Nitika
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Mohan Kumar
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India.,Knowledge Integration and Transformation Platform at Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Sarmila Mazumder
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Sunita Taneja
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| | - Nita Bhandari
- Centre for Health Research and Development, Society for Applied Studies, New Delhi, India.,Knowledge Integration and Transformation Platform at Centre for Health Research and Development, Society for Applied Studies, New Delhi, India
| |
Collapse
|
7
|
Zhang L, Gao NN, Liu HJ, Wu Q, Liu J, Zhang T, Sun J, Qi JH, Qiao XY, Zhao Y, Li Y. Differences in Postnatal Growth of Preterm Infants in Northern China Compared to the INTERGROWTH-21st Preterm Postnatal Growth Standards: A Retrospective Cohort Study. Front Pediatr 2022; 10:871453. [PMID: 35769217 PMCID: PMC9234397 DOI: 10.3389/fped.2022.871453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 05/13/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The INTERGROWTH-21st preterm postnatal growth standards (IPPGS) have increasingly been used to evaluate the growth of preterm infants worldwide. However, the validity of IPPGS's application to specific preterm populations remains controversial. This retrospective cohort study aimed to formulate reference growth charts for a preterm cohort in northern China and compare them to the IPPGS. METHODS A total of 1,827 healthy preterm infants with follow-up visits before 70 weeks of postmenstrual age (PMA) were retrospectively sampled from a preterm cohort (N = 2,011) born between 1 January 2011 and 28 February 2021, at the First Affiliated Hospital of Shandong First Medical University. Using the Generalized Additive Models for Location, Scale, and Shape method, 5,539 sets of longitudinal data were used to construct percentile and Z-score charts of length, weight, and head circumference (HC) at 40-64 weeks of PMA. Z-scores of length, weight, and HC (LAZ, WAZ, and HCZ) before 64 weeks were calculated using the IPPGS. Differences in the 50th percentile values between preterm infants and IPPGS (dLength, dWeight, and dHC) were calculated. Z-scores were assigned to six PMA clusters: 40-44, 44-48, 48-52, 52-56, 56-60, and 60-64 weeks for comparison between sexes. RESULTS For eligible infants, the mean PMA and weight at birth were 33.93 weeks and 2.3 kg, respectively. Boys, late preterm infants, twins, and infants with exclusively breastfeeding accounted for 55.8, 70.6, 27.8, and 45.9%, respectively. Compared to IPPGS, preterm infants were longer and heavier, especially for dLength in girls (range, 2.19-2.97 cm), which almost spanned the 50th and 90th percentiles of IPPGS. The dHC tended to narrow with PMA for both sexes. The mean LAZ, WAZ, and HCZ of both sexes at all PMA clusters were >0, especially for LAZ and WAZ (about 1.0 relative to IPPGS), indicating higher levels than the IPPGS at 40-64 weeks. Girls had larger LAZ at each PMA cluster, larger WAZ at 40-44 weeks, and lower HCZ after 56 weeks than boys. HCZ declined with PMA for both sexes. CONCLUSION Postnatal growth of this preterm cohort was considerably higher than that of the IPPGS at 40-64 weeks of PMA with sex differences.
Collapse
Affiliation(s)
- Li Zhang
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Nan-Nan Gao
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Hui-Juan Liu
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Qiong Wu
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Ju Liu
- Medical Research Center, Institute of Microvascular Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China
| | - Ting Zhang
- School of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Jin Sun
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Jian-Hong Qi
- Department of Neonatology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xiu-Yun Qiao
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Yan Zhao
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Yan Li
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| |
Collapse
|
8
|
Han J, Jiang Y, Huang J, Zhang Y, Zhang Y, Zhang Y, Chen X, Li Y, Yan W. Postnatal growth of preterm infants during the first two years of life: catch-up growth accompanied by risk of overweight. Ital J Pediatr 2021; 47:66. [PMID: 33726805 PMCID: PMC7968173 DOI: 10.1186/s13052-021-01019-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 03/02/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Early postanal growth of preterm infants has many effects on early and late health. However, evidence on growth pattern in Chinese preterm infant population during early life is insufficient. This study aims to describe the growth trajectory, catch-up growth, and risk of overweight of preterm infants during the first 2 years of life in a Chinese community population. METHODS All preterm infants (n = 10,624) received routine childcare in one primary maternal and child healthcare network in 8 years were included. Body weight and length/height at corrected age (CA) 40 weeks, CA 3 months, 6 months, 9 months, 12 months, 18 months, and 24 months were extracted and converted to z-scores based on the World Health Organization (WHO) standards. According to the intrauterine growth status, infants were divided into small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA) infants. Changes of z-score were used to describe the growth velocity. Generalized estimating equation (GEE) model was used to analyze growth trajectory trends over time. RESULTS Body weight and length/height were overall above the WHO standards during the first 2 years of life. Z-score increased significantly by 0.08 (95% CI: 0.06-0.10) in weight and 0.07 (95% CI: 0.04-0.09) in length/height from CA 40 weeks to 3 months and then levelled off until CA 24 months after adjustment. Almost 90% of AGA and LGA infants achieved growth targets (≥25th percentile of WHO standards), and over 85% of SGA infants achieved catch-up growth (≥10th percentile of WHO standards) before CA 24 months. However, the risk of overweight appeared during this period, with the proportion of infants with the risk of overweight being at the peak at CA 3 months (25.6% of all preterm infants and 39.4% of LGA infants). Growth trajectories of SGA showed increasing trends, but those of LGA showed decreasing trends during the first 2 years. CONCLUSIONS Body weight and length/height of preterm infants are above the WHO standards in the Chinese community population during the first 2 years of life. Catch-up growth is accompanied by risk of overweight as early as CA 3 months. (349 words).
Collapse
Affiliation(s)
- Junyan Han
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
- National Children's Medical Center, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
| | - Yuan Jiang
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
- National Children's Medical Center, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
| | - Jun Huang
- Shanghai Minhang District Maternal and Child Health Care Hospital, 805 Gudai Road, Minhang District, Shanghai, 201102, China
| | - Yue Zhang
- Shanghai Minhang District Maternal and Child Health Care Hospital, 805 Gudai Road, Minhang District, Shanghai, 201102, China
| | - Ying Zhang
- Shanghai Minhang District Maternal and Child Health Care Hospital, 805 Gudai Road, Minhang District, Shanghai, 201102, China
| | - Yi Zhang
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
- National Children's Medical Center, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
| | - Xiaotian Chen
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
- National Children's Medical Center, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China
| | - Yun Li
- Shanghai Minhang District Maternal and Child Health Care Hospital, 805 Gudai Road, Minhang District, Shanghai, 201102, China.
| | - Weili Yan
- Children's Hospital of Fudan University, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.
- National Children's Medical Center, 399 Wanyuan Road, Minhang District, Shanghai, 201102, China.
| |
Collapse
|
9
|
Zhang L, Lin JG, Liang S, Sun J, Gao NN, Wu Q, Zhang HY, Liu HJ, Cheng XD, Cao Y, Li Y. Comparison of Postnatal Growth Charts of Singleton Preterm and Term Infants Using World Health Organization Standards at 40-160 Weeks Postmenstrual Age: A Chinese Single-Center Retrospective Cohort Study. Front Pediatr 2021; 9:595882. [PMID: 33791257 PMCID: PMC8005644 DOI: 10.3389/fped.2021.595882] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 02/17/2021] [Indexed: 11/22/2022] Open
Abstract
There remains controversy regarding whether the growth charts constructed from data of term infants, such as those produced by the World Health Organization (WHO) standards, can appropriately evaluate the postnatal growth of preterm infants. This retrospective cohort study, conducted in the First Affiliated Hospital of Shandong First Medical University in Jinan China, aimed to compare the postnatal growth charts of singleton preterm and term infants using WHO standards at 40-160 weeks postmenstrual age (PMA). A total of 5,459 and 15,185 sets of longitudinal measurements [length/height, weight, head circumference (HC), and body mass index (BMI)] from birth to 160 weeks PMA were used to construct growth charts for 559 singleton preterm (mean PMA at birth, 33.84 weeks) and 1,596 singleton term infants (born at 40 weeks PMA), respectively, using the Generalized Additive Models for Location, Scale, and Shape (GAMLSS) method. Z-scores (prematurity corrected) were calculated using WHO Anthro software. Compared to WHO standards, all parameters of preterm infants were increased, especially in terms of length/height and weight; the gap between the two almost spanned two adjacent centile curves. Compared to term controls, the length/height, weight, and BMI of preterm infants were higher at 40 weeks PMA, surpassed by term infants at 52-64 weeks PMA, and quite consistent thereafter. The HC of preterm infants at 40-160 weeks PMA was quite consistent with both term controls and the WHO standards. The Z-scores for length/height, weight, and BMI of preterm infants relative to the WHO standards gradually decreased from 1.20, 1.13, and 0.74 at 40-44 weeks PMA to 0.67, 0.42, and 0.03 at 132-160 weeks PMA, respectively; Z-scores for HC of preterm infants rapidly decreased from 0.73 to 0.29 at 40-50 weeks PMA, and then fluctuated in the range of 0.08-0.23 at 50-160 weeks PMA. Preterm infants had higher growth trajectories than the WHO standards and similar but not identical trajectories to term infants during the first 2 years of life. These findings reemphasize the necessity of constructing local growth charts for Chinese singleton preterm infants.
Collapse
Affiliation(s)
- Li Zhang
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Jian-Gong Lin
- Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Shuang Liang
- Department of Pediatrics, The Second Hospital of Shandong University, Jinan, China
| | - Jin Sun
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Nan-Nan Gao
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Qiong Wu
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Hui-Yun Zhang
- Department of Pediatrics, Maternal and Child Health Care Hospital of Shandong Province, Jinan, China
| | - Hui-Juan Liu
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Xiang-Deng Cheng
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Yuan Cao
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| | - Yan Li
- Department of Developmental Pediatrics and Child Health Care, The First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital, Shandong Engineering and Technology Research Center for Pediatric Drug Development, Jinan, China
| |
Collapse
|