The EPICure study: growth and blood pressure at 6 years of age following extremely preterm birth.
BACKGROUND
Preterm children are at risk for reduced growth in early childhood, which may predispose them to later changes in blood pressure (BP).


OBJECTIVE
To study growth and BP in extremely preterm (EP) children at age 6 years.


METHODS
Children who were born at 25 completed weeks of gestation or less in the United Kingdom and Ireland in 1995 were evaluated when they reached early school age. Children underwent standardised assessments, including auxology and sitting BP.


RESULTS
Of 308 surviving children, 241 (78%) were assessed at a median age of 6 years 4 months; 160 full-term classmates acted as a comparison group. Compared with classmates, EP children were 1.2 standard deviations (SDs) lighter, 0.97 SD shorter, body mass index (BMI) was 0.95 SD lower and head circumference 1.3 SD lower. Compared with 2.5 years of age, EP children had shown "catch-up" in their weight by 0.37 SD, height by 0.42 SD and head circumference by 0.13 SD. Systolic and diastolic BP were lower by 2.3 mm Hg and 2.4 mm Hg, respectively, in EP children, but these differences were accounted for by differences in height and BMI. Maternal smoking in pregnancy was associated with lower BP. Children born before 24 weeks had higher systolic pressures and children given postnatal steroids higher diastolic pressures.


CONCLUSIONS
Poor postnatal growth seen after birth and in the third year persists into school age. Catch-up growth reduces some of the early deficit but is least for head growth. Despite serious postnatal growth restriction BP appears similar in both EP and term classmates.
School of Human Development, University of Nottingham, UK.
M A
MA
Bracewell
E M
EM
Hennessy
D
D
Wolke
N
N
Marlow
D000886:Anthropometry / Q000379:methods; D001794:Blood Pressure / Q000502:physiology; D001827:Body Height / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D002658:Developmental Disabilities; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development / Q000502:physiology*; D008297:Male; D009483:Neuropsychological Tests