Karlberg J, Albertsson-Wikland K
Department of Pediatrics, Queen Mary Hospital, University of Hong Kong.
Pediatr Res. 1995 Nov;38(5):733-9. doi: 10.1203/00006450-199511000-00017.
Intrauterine growth retardation, or being small for gestational age (SGA), has a life-long impact on a fetus's potential for development and survival. The incidence and relative risk of short stature in children born SGA were studied using a Swedish healthy full-term (37-43 wk of gestation) singleton birth cohort (n = 3650) from Göteborg, followed from birth to final height at about 18 y of age. Most infants, defined as SGA on the basis of a birth length less than -2 standard deviation scores (SDS) below the mean (SGAL infants), showed catch-up growth during the first 6 mo after birth, and by 1 y only 13.4% of the SGAL infants were below -2 SDS in height. This percentage decreased further during childhood to reach a value of 7.9% at 18 y of age. Although most SGAL infants have catch-up growth in early life, those who do not constitute 21% of short, prepubertal children. At 18 y of age, 22% of the total short population were short at birth (< -2 SDS), whereas when birth weight was used to define SGA, only 14% of the 18-y-old short population were light at birth. SGAL infants were found to have a 7-fold higher risk for short final stature (relative risk, 7.1; 95% confidence interval, 3.7-13.6) in comparison with the non-SGAL group. In a multiple linear regression analysis, both birth length and mid-parental height were found to be significantly related to the magnitude of catch-up growth from birth to 18 y of age. Neither the length of gestation nor birth weight showed such a relationship. It is concluded that the vast majority (> 86%) of "healthy" full-term singleton SGAL infants will achieve catch-up in height during the first 6-12 mo of life, and that this is almost independent of whether birth weight or birth length is used to define SGA. Of the remaining, non-catch-up SGA infants, about 50% remain short in final height, and thus constitute a high risk group for persistent short stature.
宫内生长受限，即小于胎龄儿（SGA），会对胎儿的发育和生存潜力产生终身影响。我们利用来自哥德堡的一个瑞典健康足月（妊娠37 - 43周）单胎出生队列（n = 3650），对SGA出生儿童身材矮小的发病率和相对风险进行了研究，该队列从出生一直随访至约18岁时的最终身高。大多数婴儿，即根据出生身长低于均值2个标准差评分（SDS）定义为SGA的婴儿（SGAL婴儿），在出生后的前6个月出现追赶生长，到1岁时，只有13.4%的SGAL婴儿身高低于 -2 SDS。这个百分比在儿童期进一步下降，到18岁时降至7.9%。虽然大多数SGAL婴儿在生命早期有追赶生长，但那些没有追赶生长的婴儿占青春期前矮小儿童的21%。在18岁时，全部矮小人群中有22%出生时就矮小（< -2 SDS），而当用出生体重来定义SGA时，18岁的矮小人群中只有14%出生时体重轻。与非SGAL组相比，发现SGAL婴儿最终身材矮小的风险高7倍（相对风险，7.1；95%置信区间，3.7 - 13.6）。在多元线性回归分析中，发现出生身长和父母平均身高均与从出生到18岁的追赶生长幅度显著相关。妊娠时长和出生体重均未显示出这种关系。得出的结论是，绝大多数（> 86%）“健康”的足月单胎SGAL婴儿在出生后的前6 - 12个月将实现身高追赶，而且这几乎与用出生体重还是出生身长来定义SGA无关。在其余未实现追赶生长的SGA婴儿中，约50%最终身高仍矮小，因此构成了持续性身材矮小的高危群体。
