Height at 2 and 5 years of age in children born very preterm: the EPIPAGE study.
OBJECTIVE
To evaluate growth for children born very preterm with particular focus on those born small-for-gestational age (SGA) or with ex utero growth restraint (GR), and to identify risk factors for short stature at 5 years of age.


METHODS
Population-based study of children born at less than 33 completed weeks of gestation (Étude Epidémiologique sur les Petits Ages Gestationnels (EPIPAGE)). Short stature was defined as height <-2SD on WHO growth curves. Ex utero GR was considered to have occurred in children with appropriate size for gestational age at birth and with a height and/or weight below -2SD at 2 years of corrected age. Logistic regression models were used to test associations between risk factors and short stature.


RESULTS
The authors measured height at 5 years of age for 1,597 of 2,193 children (73%), 5.6% (95% CI 4.6 to 6.9) of whom were diagnosed as having a short stature. Height was measured at 2 and 5 years of age in 1417 children. Among these, 24% of those born SGA and 36% of those with ex utero GR (p=0.002) had a short stature at 5 years. Predictors of short stature were SGA or birth length <-2SD, maternal height ≤ 160 cm, gestational age <29 weeks and systemic corticosteroids. Breastfeeding at discharge decreased the risk of short stature.


CONCLUSIONS
Short stature at 5 years of age is common in children born preterm. The highest incidence was observed in the group with ex utero GR. Systemic steroids have a long-term impact on growth and should be used with caution. Breastfeeding at discharge appeared to be protective.
Neonatal Unit, University Teaching Hospital, Hôpital Jeanne de Flandre, Lille Cedex, France. vpierrat@chru-lille.fr
V
V
Pierrat
L
L
Marchand-Martin
I
I
Guemas
J
J
Matis
A
A
Burguet
J C
JC
Picaud
J
J
Fresson
C
C
Alberge
S
S
Marret
J C
JC
Roze
M
M
Kaminski
B
B
Larroque
P Y
PY
Ancel
D000328:Adult; D001827:Body Height / Q000502:physiology*; D001835:Body Weight / Q000502:physiology; D001942:Breast Feeding / Q000706:statistics & numerical data; D004812:Epidemiologic Methods; D005260:Female; D005317:Fetal Growth Retardation / Q000453:epidemiology; D005602:France / Q000453:epidemiology; D005865:Gestational Age; D005938:Glucocorticoids / Q000009:adverse effects; D006130:Growth Disorders / Q000196:embryology / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D007236:Infant, Small for Gestational Age / Q000254:growth & development*; D008297:Male; D055815:Young Adult
D005938:Glucocorticoids