根据出生时的生长状况和成熟度，矮小儿童成年后的生长模式。

Growth Patterns of Children With Short Stature in Adulthood According to Auxological Status and Maturity at Birth.

机构信息

Hospital for Children and Adolescents, University of Leipzig, 04103 Leipzig, Germany.

CrescNet Database, University of Leipzig, 04103 Leipzig, Germany.

出版信息

J Clin Endocrinol Metab. 2022 Nov 25;107(12):3320-3327. doi: 10.1210/clinem/dgac510.

DOI:10.1210/clinem/dgac510

PMID:36099499

Abstract

CONTEXT

Prematurity carries a risk for impaired postnatal growth and long-term growth restriction. Especially children born SGA seem vulnerable for poor growth, as a persistent short stature can be observed in app 10-15% of these children.

OBJECTIVE

In this study we aimed to recognize differences in growth patterns of children according to sex, maturity, and auxological status at birth facilitating earlier identification of small-for-gestational-age (SGA) children with adult short stature.

METHODS

The growth data of 44 791 infants born between January 1, 1980, and December 30, 2012, among 2 pediatric cohorts with follow-up through December 31, 2020, were analyzed. A total of 5698 children with birth data had measurements at near final height (nfh) and at least 2 further points.

RESULTS

Preterm children (gestational age < 37 weeks) had a significantly lower mean nfh SDS than term children (preterm, -0.61; term, -0.18) and a higher likelihood of nfh < third percentile (preterm, 20.5%; term, 12.2%). SGA born children also had a lower mean nfh SD score (SDS) than children born appropriate for gestational age (AGA) (SGA, -1.06; AGA, -0.15) and a higher likelihood of nfh < third percentile (SGA, 28.2%; AGA 10.1%). Of 1204 SGA children, 672 (56%) showed successful catch-up growth (CUG) to nfh greater than or equal to the 10th percentile (SGA-CU), and 532 children (44%) did not (SGA-S). The difference in their mean nfh SDS (SGA-CU, -0.12; SGA-S -2.26) can only partly be explained by the differences in mean mid-parental height SDS (SGA-CU, -0.3; SGA-S, -1.19). During the first year, SGA-CU showed higher CUG (SGA-CU, +1.2 SDS; SGA-S, +0.45 SDS), which helps to discriminate between groups earlier.

CONCLUSION

Final growth outcome was influenced by prematurity and auxological status at birth, but not by sex. Height/length SDS increments during year 1 are instrumental to discern SGA children with later normal or short stature. While observing CUG until year 2 and 3 can add specificity, discrimination thereafter becomes difficult.

摘要

背景

早产会增加出生后生长受限和长期生长受限的风险。特别是出生时 SGA 的儿童似乎容易生长不良，因为这些儿童中约有 10-15%会持续出现身材矮小。

目的

本研究旨在根据性别、成熟度和出生时的人体测量学状况识别儿童的生长模式差异，从而更早地识别出有成年身材矮小风险的 SGA 儿童。

方法

分析了 1980 年 1 月 1 日至 2012 年 12 月 30 日期间在两个儿科队列中出生的 44791 名婴儿的生长数据，这些队列均随访至 2020 年 12 月 31 日。共有 5698 名具有出生数据的儿童在接近最终身高 (nfh) 时和至少另外两个时间点时进行了测量。

结果

早产儿（胎龄 <37 周）的 nfh SDS 平均值明显低于足月儿（早产儿，-0.61；足月儿，-0.18），且 nfh < 第 3 百分位数的可能性更高（早产儿，20.5%；足月儿，12.2%）。出生时 SGA 的儿童的 nfh SDS 平均值也低于出生时适合胎龄 (AGA) 的儿童（SGA，-1.06；AGA，-0.15），且 nfh < 第 3 百分位数的可能性更高（SGA，28.2%；AGA，10.1%）。在 1204 名 SGA 儿童中，有 672 名（56%）成功实现了 nfh 大于或等于第 10 百分位数（SGA-CU）的追赶性生长（CUG），532 名（44%）未实现（SGA-S）。他们的 nfh SDS 平均值的差异（SGA-CU，-0.12；SGA-S，-2.26）只能部分解释为中亲身高 SDS 平均值的差异（SGA-CU，-0.3；SGA-S，-1.19）。在第一年中，SGA-CU 表现出更高的 CUG（SGA-CU，+1.2 SDS；SGA-S，+0.45 SDS），这有助于更早地区分两组。