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出生时生长受限儿童在整个童年期的生长情况。

Growth throughout childhood of children born growth restricted.

作者信息

Beukers Fenny, Rotteveel Joost, van Weissenbruch Mirjam M, Ganzevoort Wessel, van Goudoever Johannes B, van Wassenaer-Leemhuis Aleid G

机构信息

Department of Paediatrics, Academic Medical Center, Amsterdam, The Netherlands.

Department of Paediatrics, VU University Medical Center, Amsterdam, The Netherlands.

出版信息

Arch Dis Child. 2017 Aug;102(8):735-741. doi: 10.1136/archdischild-2016-312003. Epub 2017 Mar 30.

Abstract

OBJECTIVE

Many studies that examine growth in growth-restricted children at birth do not discriminate between fetal growth restriction (FGR) and small for gestational age (SGA). These terms however are not synonymous. In SGA, stunting and increased weight gain have been reported. We do not know if this holds true for FGR. Our aim was to study postnatal growth until age 12.5 years in a cohort of children born FGR due to early onset placental insufficiency, and its relation to FGR severity.

DESIGN

Prospective cohort study, follow-up of an antenatal randomised controlled trial in two tertiary centres.

PATIENTS

Children aged 12.5 years born after FGR, with mothers who had severe early onset hypertensive pregnancy disorders (N=96).

MAIN OUTCOME MEASURES

Anthropometry at age 12.5 years in SD scores (SDS).

RESULTS

Mean height SDS (SD) corrected for target height was -0.09 (0.94), mean body mass index (BMI) SDS was 0.00 (1.16) and mean head circumference SDS was -0.37 (1.11). Catch-up growth was at fastest rate between term age and 3 months and similar for height (0.55 SDS/months) and weight (0.49 SDS/months). Neither FGR severity nor gestational age was related to height and BMI at age 12.5 years.

CONCLUSIONS

Children born growth restricted due to early onset placental insufficiency have height and BMI scores comparable to their age-matched peers at age 12.5 years. FGR severity was not related to height and BMI at age 12.5 years. These reassuring results differ from most studies that examine SGA children.

摘要

目的

许多研究在探讨出生时生长受限儿童的生长情况时,并未区分胎儿生长受限(FGR)和小于胎龄儿(SGA)。然而,这两个术语并非同义词。在小于胎龄儿中,曾有发育迟缓及体重增加加快的报道。我们尚不清楚这在胎儿生长受限中是否同样成立。我们的目的是研究因早发性胎盘功能不全而出生时患有胎儿生长受限的一组儿童至12.5岁时的出生后生长情况,及其与胎儿生长受限严重程度的关系。

设计

前瞻性队列研究,对两个三级中心的一项产前随机对照试验进行随访。

研究对象

胎儿生长受限后出生的12.5岁儿童,其母亲患有严重早发性高血压妊娠疾病(N = 96)。

主要观察指标

12.5岁时按标准差评分(SDS)进行的人体测量。

结果

根据目标身高校正后的平均身高SDS(标准差)为-0.09(0.94),平均体重指数(BMI)SDS为0.00(1.16),平均头围SDS为-0.37(1.11)。追赶生长在足月至3个月时最快,身高(0.55 SDS/月)和体重(0.49 SDS/月)的追赶速度相似。胎儿生长受限的严重程度和胎龄均与12.5岁时的身高和BMI无关。

结论

因早发性胎盘功能不全而出生时生长受限的儿童在12.5岁时的身高和BMI评分与年龄匹配的同龄人相当。胎儿生长受限的严重程度与12.5岁时的身高和BMI无关。这些令人安心的结果与大多数研究小于胎龄儿的研究不同。

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