title: Postnatal growth of preterm born children ≤ 750g at birth.
abstract: BACKGROUND
  Extremely low birth weight (ELBW) infants are at risk of impaired postnatal growth. Impaired postnatal growth has been reported to be associated with delayed cognitive and motor development.
  
  
  OBJECTIVE
  To describe postnatal growth patterns of appropriate and small for gestational age (AGA and SGA) ELBW children in relation to their cognitive and motor outcome at age 5.5.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  One hundred one children with a BW ≤ 750g, born between 1996 and 2005 in the University Hospital Utrecht, The Netherlands.
  
  
  METHODS
  Height (Ht), weight (Wt), occipital-frontal circumference (OFC) at birth, 15 months and 2 years corrected age and 3.5 and 5.5 years. Cognitive and motor outcome at 5.5 years of age, classified as normal (Z-score ≥-1), mildly delayed (-2≤Z-score <-1) or severely delayed (Z-score <-2). AGA (Ht, Wt or OFC at birth ≥-2 SDS) infants were compared with SGA (Ht, Wt or OFC at birth <-2 SDS) infants.
  
  
  RESULTS
  Between birth and 5.5 years catch-up growth in Ht, weight for height (Wt/Ht), Wt and OFC was seen in 72.2%, 55.2%, 28.6% and 68.9% respectively of the SGA infants. For AGA infants we found substantial catch-down growth in Ht (15.4%) and Wt (33.8%). Cognitive and motor outcome was normal in 76.2% and 41.6% of the 101 children. A significantly higher percentage of normal cognitive outcome was found in AGA infants with Wt growth remaining at ≥-2 SDS compared to AGA infants with catch-down growth (83% vs 63%). Next, SGA infants who caught-up in OFC had a higher prevalence of normal cognitive outcome compared to SGA infants who did not catch-up in OFC. Furthermore, a higher percentage of severely delayed motor outcome was found in SGA infants without catch-up growth in Wt compared to SGA infants who caught-up in Wt (61.5% vs 32.2%).
  
  
  CONCLUSIONS
  Catch-up growth in Ht, Wt/Ht and OFC occurred in the majority of the SGA infants with a BW ≤ 750 g, but was less common in Wt. AGA children who remained their Wt at ≥-2 SDS have a better cognitive and motor developmental outcome at 5.5 years of age. Catch-up growth in OFC was associated with a better cognitive outcome at 5.5 years of age.
authors.affiliation: Department of Obstetrics, University Medical Centre, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
authors.forename: M J
authors.initials: MJ
authors.lastname: Claas
authors.forename: L S
authors.initials: LS
authors.lastname: de Vries
authors.forename: C
authors.initials: C
authors.lastname: Koopman
authors.forename: M M A
authors.initials: MM
authors.lastname: Uniken Venema
authors.forename: M J C
authors.initials: MJ
authors.lastname: Eijsermans
authors.forename: H W
authors.initials: HW
authors.lastname: Bruinse
authors.forename: A A
authors.initials: AA
authors.lastname: Verrijn Stuart
mesh_terms: D001827:Body Height / Q000502:physiology; D001835:Body Weight / Q000502:physiology; D002657:Child Development / Q000502:physiology*; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006257:Head / Q000033:anatomy & histology; D006801:Humans; D052577:Infant, Extremely Low Birth Weight / Q000254:growth & development*; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D007236:Infant, Small for Gestational Age / Q000254:growth & development*; D008297:Male; D009426:Netherlands; D012189:Retrospective Studies; D018709:Statistics, Nonparametric