Institute of Maternal and Child Research, Faculty of Medicine, University of Chile, Santiago de Chile, Chile.
Unit of Neonatology, Department of Pediatrics Hospital San Borja Arriaran, Santiago de Chile, Chile.
Horm Res Paediatr. 2018;89(4):233-245. doi: 10.1159/000487994. Epub 2018 May 15.
BACKGROUND/AIMS: An increased preterm birth survival rate is associated with long-term neurological and metabolic risks; thus, our aim was to evaluate whether early patterns of infancy anthropometry and metabolic hormonal profile differ in preterm infants born small for gestational age (SGA) or appropriate for gestational age (AGA) from birth to 36 months of corrected age (CA).
We recruited 110 very-low-birth-weight (VLBW) preterm infants (AGA = 60 and SGA = 50) with a mean birth weight of -2.39 ± 0.77 versus 0.57 ± 0.54 standard deviation scores (SDS) (p < 0.01) and birth length of -2.1 ± 1.05 versus -0.44 ± 0.82 SDS (p < 0.01), respectively. Anthropometry and blood sampling for insulin, insulin-like growth factor (IGF)-II, IGF-I, and leptin were performed for up to 3 years.
All neonates increased their weight, length, and head circumference SDS during the early inpatient period. Up to 90% reached a normal length within this period. The IGF-II, insulin, and glycemia concentrations changed in parallel with weight. In the first year of CA, only SGA infants gained weight and height SDS. The homoeostatic model assessment had a trend toward higher values in SGA infants at 24 and 36 months (p = 0.06 and p = 0.07).
Being SGA is the strongest predictor of early recovery of height in VLBW preterm infants. Follow-up will allow us to determine whether the differences in the growth patterns of VLBW preterm infants by birth weight SDS persist.
背景/目的：早产儿的存活率增加与长期神经和代谢风险相关；因此，我们的目的是评估从出生到 36 个月校正年龄（CA），出生体重小于胎龄（SGA）或适于胎龄（AGA）的早产儿在婴儿期的体型和代谢激素特征是否存在早期差异。
我们招募了 110 名极低出生体重（VLBW）早产儿（AGA=60 例，SGA=50 例），平均出生体重分别为-2.39±0.77 和 0.57±0.54 标准差评分（SDS）（p<0.01），出生长度分别为-2.1±1.05 和-0.44±0.82 SDS（p<0.01）。对胰岛素、胰岛素样生长因子（IGF）-II、IGF-I 和瘦素进行了长达 3 年的人体测量和采血。
所有新生儿在住院期间体重、长度和头围 SDS 均增加。在此期间，高达 90%的新生儿达到了正常长度。IGF-II、胰岛素和血糖浓度与体重变化平行。在 CA 的第一年，仅 SGA 婴儿增加了体重和身高 SDS。稳态模型评估在 24 和 36 个月时 SGA 婴儿的值有增高趋势（p=0.06 和 p=0.07）。
SGA 是 VLBW 早产儿早期恢复身高的最强预测因素。随访将使我们能够确定 VLBW 早产儿出生体重 SDS 生长模式的差异是否持续存在。
