Powls A, Botting N, Cooke R W, Pilling D, Marlow N
Institute of Child Health, Alder Hey Children's Hospital, Liverpool.
Arch Dis Child Fetal Neonatal Ed. 1996 Nov;75(3):F152-7. doi: 10.1136/fn.75.3.f152.
To compare the growth of very low birthweight (VLBW) children in early adolescence with that of their normal birthweight peers; to examine the role of factors contributing to growth-parental height, perinatal variables, bone maturity and sexual maturation; to examine the correlation between head growth and cognitive and educational outcome.
Standing and sitting heights, weight, occipito-frontal circumference (OFC), skinfold thicknesses and pubertal staging were assessed in 137 VLBW children and 160 controls at 11-13.5 years of age. Ninety six (70%) of the VLBW children had their bone age assessed using the TW2 method. Reported parental heights were obtained by questionnaire. All children had standardised tests of cognitive and educational ability. Perinatal data had been collected prospectively as part of a longitudinal study.
VLBW children had lower heights, weight, and OFC. Skinfold thicknesses were no different. The children's short stature was not accounted for by difference in parental height, degree of pubertal development, or by retarded bone age. Indeed, the TW2 RUS score was significantly advanced in the VLBW children. Using the bone ages to predict final adult height, 17% have a predicted height below the third centile and 33% below the tenth. Weight was appropriate for height, but there was a residual deficiency in OFC measurements after taking height into account. In the VLBW group smaller head size was associated with lower IQ and mathematics and reading scores.
Growth problems persist in VLBW children and final heights may be even more abnormal than present heights suggest. VLBW children have smaller OFCs than expected from their short stature alone and this may be associated with poorer educational and cognitive outcomes.
比较极低出生体重（VLBW）儿童在青春期早期与其正常出生体重的同龄人之间的生长情况；研究影响生长的因素——父母身高、围产期变量、骨成熟度和性成熟——所起的作用；研究头部生长与认知及教育结果之间的相关性。
对137名极低出生体重儿童和160名对照儿童在11至13.5岁时进行了身高（站立和坐高）、体重、枕额周长（OFC）、皮褶厚度和青春期分期评估。96名（70%）极低出生体重儿童采用TW2方法评估了骨龄。通过问卷调查获取父母报告的身高。所有儿童都进行了认知和教育能力的标准化测试。围产期数据作为一项纵向研究的一部分已前瞻性收集。
极低出生体重儿童的身高、体重和枕额周长较低。皮褶厚度无差异。儿童的身材矮小不能用父母身高差异、青春期发育程度或骨龄延迟来解释。事实上，极低出生体重儿童的TW2 RUS评分明显提前。用骨龄预测最终成人身高时，17%的儿童预测身高低于第三百分位数，33%低于第十百分位数。体重与身高相符，但考虑身高因素后枕额周长测量仍有残余不足。在极低出生体重组中，较小的头围与较低的智商、数学和阅读分数相关。
极低出生体重儿童的生长问题持续存在，最终身高可能比目前身高显示的更异常。极低出生体重儿童的枕额周长比仅根据其身材矮小预期的要小，这可能与较差的教育和认知结果相关。
