Hospital for Children and Adolescents, University of Leipzig, 04103 Leipzig, Germany.
CrescNet Database, University of Leipzig, 04103 Leipzig, Germany.
J Clin Endocrinol Metab. 2022 Nov 25;107(12):3320-3327. doi: 10.1210/clinem/dgac510.
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.
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.
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.
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.
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.
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。
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。
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。
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。
最终生长结果受早产和出生时人体测量学状况的影响，但不受性别的影响。第一年身高/长度 SDS 的增加有助于辨别后期身高正常或矮小的 SGA 儿童。虽然观察到第二年和第三年的 CUG 可以提高特异性，但此后的鉴别就变得困难了。
