The effect of perinatal risk factors on growth in very preterm infants at 2 years of age: the Leiden Follow-Up Project on Prematurity.
OBJECTIVE
To describe growth in infants <32 weeks GA. To assess the relationship between growth and perinatal factors (like intrauterine growth retardation and the postnatal use of dexamethasone) and neurodevelopmental outcome.


METHODS
Regional, prospective study in two health regions in the Netherlands. Part of the Leiden Follow-Up Project on Prematurity (LFUPP).


METHODS
196 live born infants with GA <32 weeks.


METHODS
At two years corrected age length, weight and head circumference of 160 of 196 surviving infants (82%) were evaluated. Standard Deviation Scores were calculated and means were compared to Dutch growth references. Mean SDS for length was corrected for the mean SDS for target height. Birth weight (BW)-SDS for gestational age (GA) was calculated according to Swedish references.


RESULTS
Length, weight and weight-for-length were equally impaired in both sexes at two years in premature infants compared to Dutch growth charts. Catch-up in length and weight occurred mostly in the first year of life. Intrauterine growth retardation was associated with impairment of all growth parameters. The use of postnatal dexamethasone was associated with shorter length, lower weight, lower weight for length and smaller head circumference; this effect remained after correction for GA, BW and BW-SDS. Growth retardation (length and weight) was associated with an abnormal neurologic examination; smaller head circumference also with mental and psychomotor delay.


CONCLUSIONS
Growth at two years corrected age in children born <32 weeks is impaired. Postnatal dexamethasone is associated with impairment of all growth parameters including head circumference, which may be a significant contributing factor for abnormal neurodevelopmental outcome.
Rijken
Monique
M
Department of Paediatrics, Leiden University Medical Center, Leiden, the Netherlands. M.Rijken@lumc.nl
Wit
Jan M
JM
Le Cessie
Saskia
S
Veen
Sylvia
S
D001827:Body Height; D001835:Body Weight; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011247:Pregnancy; D047928:Premature Birth; D012307:Risk Factors