Growth and development in preterm infants small for gestational age.

The growth pattern and neurologic and developmental performance of 21 preterm infants small for gestational age and 20 preterm infants appropriate for gestational age (birth weight less than 1500 gm) were prospectively studied. The two groups had comparable birth weight, sex, perinatal morbidities, and socioeconomic status. All infants with congenital anomalies or genetic defects were excluded. Nineteen of 21 SGA (90%) and 16 of 20 AGA (80%) infants born in 1975 or 1976 were evaluated in our follow-up program until 5 years of age. At 1 year of age, the weights and lengths of the SGA infants were comparable to those of their AGA counterparts; AGA infants were significantly heavier, however, at 2, 3, 4, and 5 years of age. In addition, AGA infants were significantly taller at 2, 3, and 5 years. Neurologic evaluation of 5 years showed a comparable rate of major abnormalities between the SGA (15%) and AGA (12%) children. Minor neurologic abnormalities were present in 26% of SGA and 12% of AGA children. Linear-regression analysis demonstrated a positive relationship between socioeconomic status and developmental outcome for both SGA and AGA children at 5 years of age. Although SGA infants scored significantly lower in developmental performance at 9 months through 3 years of age, at 4 to 5 years of age this difference was no longer observed. These observations indicate the importance of long-term follow-up.