Perinatal predictors of growth patterns to 18 months in children born small for gestational age.

AIM

To determine factors before or at birth that are predictive of growth patterns to 18 months in children born small for gestational age (SGA).

METHODS

Prospective cohort study of 186 SGA babies. Catch-up growth patterns were defined as early (>10th centile at 6 and 18 months), late (<10th centile at 6 months but >10th centile at 18 months), transient (>10th centile at 6 months but <10th centile at 18 months) or none (<10th centile at 6 and 18 months).

RESULTS

Most children (75%) showed catch-up growth by 6 months. Of antenatal variables studied, only early gestation at diagnosis of SGA predicted late or failed catch-up. Late or failed catch-up was also associated with short gestation, small absolute and relative size at birth, increased placental weight/birthweight ratio (Pl/BW) and prolonged neonatal hospital stay. On logistic regression, both late and failed catch-up were associated with short birth length. Late catch-up growth was also associated with prolonged hospital stay and male sex. Failed catch-up was associated with increased Pl/BW. No antenatal or perinatal variables distinguished early from transient catch-up groups.

CONCLUSION

SGA babies with late onset and less severe growth restriction have a good chance of catch-up growth by 6 months of age. Catch-up growth is likely to be delayed in SGA babies who are short at birth, are boys, and have prolonged hospital stays. However, poor growth over the first 6 months does not predict later growth patterns. Failure of catch-up growth in babies with increased Pl/BW may reflect an intrinsic growth defect. Transient catch-up growth may reflect environmental factors operating after birth.