MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Department of Neonatology, Affiliated Hospital of Luzhou Medical College, Luzhou, Sichuan, China.
MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
J Pediatr. 2015 Jan;166(1):54-8. doi: 10.1016/j.jpeds.2014.09.025. Epub 2014 Oct 23.
To identify an optimal growth trajectory for term small for gestational age (SGA) babies from birth to 7-years-old.
Data were from the Collaborative Perinatal Project, a US multicenter prospective cohort study from 1959-1976. Five weight growth trajectories of the 1957 term SGA babies were grouped by a latent class model. We selected the optimal growth pattern based on the lowest overall risks of childhood diseases.
Compared with appropriate for gestational age children, SGA babies with no catch-up growth (439, 22.4%) had higher risks of infection in infancy (aOR 1.2, 95% CI 1.0-1.6), growth restriction (11.2, 8.6-14.6), and low IQ (2.1, 1.7-2.8) at age 7 years. Those with excessive catch-up growth (176, 8.9%) had higher risks of overweight/obesity (7.5, 5.4-10.5) and elevated blood pressure (1.7, 1.1-2.4) at age 7 years. Babies with slow catch-up growth (328, 16.8%) or regression after 4 months (285, 14.6%) were associated with higher risks of low IQ (1.6, 1.2-2.1) and growth restriction (2.2, 1.5-3.2), respectively. Only babies with appropriate catch-up growth (729, 37.3%) did not have increased risk of adverse outcomes. Further, we also tested linear growth trajectories with similar findings.
The optimal growth trajectory for term SGA infants may be fast catch-up growth to about the 30th percentile in the first several months, with modest catch-up growth thereafter, to be around the 50th percentile by 7-years-old.
确定从出生到 7 岁的足月小于胎龄儿（SGA）的最佳生长轨迹。
数据来自美国 1959 年至 1976 年的多中心前瞻性队列研究——合作围产期项目。通过潜在类别模型对 1957 例足月 SGA 婴儿的 5 种体重增长轨迹进行分组。我们根据儿童疾病的总体风险最低选择最佳生长模式。
与适于胎龄儿相比，未出现追赶生长的 SGA 婴儿（439 例，22.4%）在婴儿期感染的风险更高（aOR 1.2，95%CI 1.0-1.6）、生长受限（11.2，8.6-14.6）和智商较低（2.1，1.7-2.8）。那些出现过度追赶生长的婴儿（176 例，8.9%）超重/肥胖的风险更高（7.5，5.4-10.5）和血压升高（1.7，1.1-2.4）。生长缓慢（328 例，16.8%）或 4 个月后体重下降（285 例，14.6%）的婴儿，其智商较低（1.6，1.2-2.1）和生长受限（2.2，1.5-3.2）的风险更高。只有适当追赶生长的婴儿（729 例，37.3%）没有增加不良结局的风险。进一步，我们还测试了具有类似发现的线性生长轨迹。
足月 SGA 婴儿的最佳生长轨迹可能是在最初几个月内快速追赶生长至第 30 百分位左右，此后适度追赶生长，到 7 岁时达到第 50 百分位左右。
